Provider Demographics
NPI:1215944897
Name:SCHWARTZ, MARY ELIZABETH (MA LCPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MA LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34 COUNTRY CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461
Mailing Address - Country:US
Mailing Address - Phone:708-747-7667
Mailing Address - Fax:708-747-8599
Practice Address - Street 1:151 NORTH MICHIGAN AVENUE
Practice Address - Street 2:#805
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601
Practice Address - Country:US
Practice Address - Phone:708-912-0755
Practice Address - Fax:708-747-8599
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634558OtherBLUE CROSS BLUE SHIELD