MEDICARE: ELIZABETH WHITNEY DEVANEY LCSW

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
1	1041C0700X	Clinical Social Worker		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2232829	OTHER	IL	BLUE CROSS BLUE SHEILD

General Provider Information

NPI Number	:	1588643399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH WHITNEY DEVANEY LCSW

Provider Business Mailing Address
First Line	:	2335 HUDSON CIR
Second Line	:	AURORA
City	:	AURORA
State	:	IL
Zip	:	60502-7338
Country	:	US
Telephone Number	:	630-788-1573
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 SPALDING DR
Second Line	:	NAPERVILLE
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6508
Country	:	US
Telephone Number	:	630-527-5484
Fax Number	:	630-527-5488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	07/08/2007

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