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General NPI Number Information
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NPI Number | 1104209618
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Entity Type | Organization
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Legal Business Name | ELIZABETH SAVAGE PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 5210 N MAGNOLIA AVE APT. 3E
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City | CHICAGO
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State | IL
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Zip | 60640-2203
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Country | US
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Telephone | 773-860-8779
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 W BELMONT AVE SUITE 407
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City | CHICAGO
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State | IL
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Zip | 60657-3200
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Country | US
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Telephone | 773-860-8779
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. ELIZABETH RACHAEL SAVAGE
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Credential | LCPC
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Telephone | 773-860-8779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.008339
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License Number State | IL
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