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NPI Code Detail

MEDICARE: DR. CONNIE BEA NATVIG PHD

MEDICARE:  DR. CONNIE BEA NATVIG  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist071004997IL

General Provider Information

NPI Number : 1114902962
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CONNIE BEA NATVIG PHD
Provider Business Mailing Address
First Line : 477 E BUTTERFIELD RD STE 107
Second Line :
City : LOMBARD
State : IL
Zip : 60148-5622
Country : US
Telephone Number : 708-955-4950
Fax Number : 708-310-3486
Provider Business Practice Location Address
First Line : 477 E BUTTERFIELD RD STE 107
Second Line :
City : LOMBARD
State : IL
Zip : 60148-5622
Country : US
Telephone Number : 708-955-4950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 09/30/2025

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Directions to “ DR. CONNIE BEA NATVIG PHD” Practice Location

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