Provider Demographics
NPI:1154557510
Name:LIU, TAO
Entity type:Individual
Prefix:
First Name:TAO
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NAPER VL WHEATON RD STE 209F
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1558
Mailing Address - Country:US
Mailing Address - Phone:630-877-6668
Mailing Address - Fax:
Practice Address - Street 1:1555 NAPERVILLE WHEATON RD STE 209F
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1558
Practice Address - Country:US
Practice Address - Phone:630-283-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043235A103T00000X, 103TC0700X, 103TC0700X
IL071010500103TC0700X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical