Healthcare Provider Details

I. General information

NPI: 1619859626
Provider Name (Legal Business Name): KAREN BETH LIEB
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24647 N MILWAUKEE AVE
VERNON HILLS IL
60061-1567
US

IV. Provider business mailing address

1780 DELAWARE TRL
WHEELING IL
60090-5124
US

V. Phone/Fax

Practice location:
  • Phone: 847-377-7950
  • Fax:
Mailing address:
  • Phone: 847-609-7835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number041243711
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: