MEDICARE: ELIZABETH A GUILFOILE LMFT

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	106H00000X	Marriage & Family Therapist	MFT000417	CT
2	106H00000X	Marriage & Family Therapist	MFT001041	GA
3	106H00000X	Marriage & Family Therapist	166001109	IL

General Provider Information

NPI Number	:	1932342383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A GUILFOILE LMFT

Provider Business Mailing Address
First Line	:	6430 N WAYNE AVE UNIT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-5116
Country	:	US
Telephone Number	:	770-540-1207
Fax Number	:

Provider Business Practice Location Address
First Line	:	6430 N WAYNE AVE UNIT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-5116
Country	:	US
Telephone Number	:	770-540-1207
Fax Number	:

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

Provider Enumeration Date	:	04/15/2009
Last Update Date	:	04/06/2018

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