MEDICARE: MRS. AMIE ELIZABETH FRITZ LCPC

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	101Y00000X	Counselor	180.008041	IL

General Provider Information

NPI Number	:	1841568375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMIE ELIZABETH FRITZ LCPC

Provider Business Mailing Address
First Line	:	18161 MORRIS AVE STE 204
Second Line	:
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-2141
Country	:	US
Telephone Number	:	708-957-3303
Fax Number	:

Provider Business Practice Location Address
First Line	:	18161 MORRIS AVE STE 204
Second Line	:
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-2141
Country	:	US
Telephone Number	:	708-957-3303
Fax Number	:

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

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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