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General NPI Number Information
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NPI Number | 1144263807
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Entity Type | Individual
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Provider Name | ELIZABETH JEAN GALLICHIO LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HINES VA HOSPITAL ROOSEVELT AND 5TH AVE.
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City | HINES
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State | IL
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Zip | 60141-5000
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Country | US
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Telephone | 708-202-4128
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Fax | 708-202-4954
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Provider Business Mailing Address
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Address Line | 1263 E OAKTON ST
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City | DES PLAINES
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State | IL
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Zip | 60018-2137
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Country | US
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Telephone | 847-298-5445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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