| Doctor Name: | LYZ AMARILLO |
| NPI Number: | 1346518594 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 178007190 |
| Business Practice Address: | 10001 Grand Ave Franklin Park, IL - 601312563 |
| Business Phone Number: | 8474510330 |
| Business Fax Number: | 8474511652 |
| Mailing Address: | 10001 Grand Ave, FRANKLIN PARK |
| State: | IL |
| Postal Code: | 601312563 |
| Phone Number: | 8474510330 |
| Fax Number: | 8474511652 |
| NPI Enumeration Date: | 12/02/2011 |
| NPI Last Update Date: | 12/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178007190 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |