Smith, Elizabeth Nicole

Smith, Elizabeth Nicole is an individual health care provider with primary practice located at 11800 S 75Th Ave Ste 300 , Palos Heights IL 60463-1064. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Smith, Elizabeth Nicole can be contacted via phone (708) 671-8440.

Contact Information

Primary practice address
11800 S 75Th Ave Ste 300 Palos Heights IL 60463-1064
Fax: (708) 671-8664
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20043115A Indiana

Profile Details

NPI number 1043712433
LBN Legal business name Smith, Elizabeth Nicole
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2018
Last updated Apr 29th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043712433 NPPES
Illinois Other 071.010238 LICENSE NUMBER

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