Healthcare Provider Details

I. General information

NPI: 1265363535
Provider Name (Legal Business Name): ELIZABETH GATTUSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 MC DOWELL RD STE 305
NAPERVILLE IL
60563-6507
US

IV. Provider business mailing address

314 S WALNUT ST
ITASCA IL
60143-2138
US

V. Phone/Fax

Practice location:
  • Phone: 630-689-1022
  • Fax:
Mailing address:
  • Phone: 224-241-0837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.116012
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: