1588643399 NPI number — ELIZABETH WHITNEY DEVANEY LCSW

Table of content: ELIZABETH WHITNEY DEVANEY LCSW (NPI 1588643399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588643399 NPI number — ELIZABETH WHITNEY DEVANEY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVANEY
Provider First Name:
ELIZABETH
Provider Middle Name:
WHITNEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEVANEY
Provider Other First Name:
LIZA
Provider Other Middle Name:
W
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1588643399
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2335 HUDSON CIR
Provider Second Line Business Mailing Address:
AURORA
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60502-7338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-788-1573
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 SPALDING DR
Provider Second Line Business Practice Location Address:
NAPERVILLE
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60540-6508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-527-5484
Provider Business Practice Location Address Fax Number:
630-527-5488
Provider Enumeration Date:
01/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2232829 . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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