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General NPI Number Information
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NPI Number | 1922192772
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Entity Type | Individual
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Provider Name | ELIZABETH THOMPSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 841 MASON LN
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4458
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Country | US
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Telephone | 847-344-5858
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Fax | 847-253-4597
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Provider Business Mailing Address
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Address Line | 841 MASON LN
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4458
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Country | US
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Telephone | 847-344-5858
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Fax | 847-253-4597
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071003390
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1843
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 071003390
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071003390
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License Number State | IL
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