| Doctor Name: | DR. ELIZABETH J FAZIO |
| NPI Number: | 1518054386 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 071007381 |
| Business Practice Address: | 211 Robert Parker Coffin Rd Suite Long Grove, IL - 600479616 |
| Business Phone Number: | 7088998150 |
| Business Fax Number: | 6304108336 |
| Mailing Address: | 435 Grant St, LEMONT |
| State: | IL |
| Postal Code: | 604394012 |
| Phone Number: | 7088998150 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071007381 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |