Healthcare Provider Details

I. General information

NPI: 1104348101
Provider Name (Legal Business Name): LIZABETH R. LORING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 N LINCOLN AVE STE 317
CHICAGO IL
60657-3119
US

IV. Provider business mailing address

1157 W NEWPORT AVE UNIT H
CHICAGO IL
60657-1500
US

V. Phone/Fax

Practice location:
  • Phone: 708-406-9870
  • Fax:
Mailing address:
  • Phone: 847-977-8469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.030734
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: