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NPI Code Detail

MEDICARE: DR. ELISSA LOUISE SARNO PHD

MEDICARE: DR. ELISSA LOUISE SARNO PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist071010624IL

General Provider Information

NPI Number : 1174295901
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELISSA LOUISE SARNO PHD
Provider Business Mailing Address
First Line : 333 N MICHIGAN AVE STE 2400
Second Line :
City : CHICAGO
State : IL
Zip : 60601-4040
Country : US
Telephone Number : 872-231-2181
Fax Number :
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 2400
Second Line :
City : CHICAGO
State : IL
Zip : 60601-4040
Country : US
Telephone Number : 773-609-0361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2021
Last Update Date : 09/30/2021

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