NPI Code Details Logo

NPI 1144213323

NPI 1144213323 : ELIZABETH F. FELDMAN PH.D. : NORTHFIELD, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1144213323
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ELIZABETH F. FELDMAN PH.D.
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/24/2005
-----------------------------------------------------
    Last Update Date     |    05/25/2016
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    778 W FRONTAGE RD SUITE 115
-----------------------------------------------------
    City                 |    NORTHFIELD
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60093-1209
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-501-3620
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    778 W FRONTAGE RD SUITE 115
-----------------------------------------------------
    City                 |    NORTHFIELD
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60093-1209
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-501-3620
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    071003782
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.