Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1952916041 |
---|---|
Provider Name | Elizabeth Rose Hein |
First Address | Chicago, IL 60633-1221 |
Second Address | Chicago, IL 60649-3233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2020 |
Last Update Date | 15/09/2020 |