Healthcare Provider Details

I. General information

NPI: 1609734607
Provider Name (Legal Business Name): ELIZABETH MARIE CIBURA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 CRISSEY AVE STE 200
GENEVA IL
60134-3069
US

IV. Provider business mailing address

22 CRISSEY AVE SUITE 200
GENEVA IL
60134
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-7770
  • Fax:
Mailing address:
  • Phone: 630-232-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number149.030956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: