Provider Demographics
NPI:1164574570
Name:COOPER, LIZBETH K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LIZBETH
Middle Name:K
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E WOODFIELD ROAD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5113
Mailing Address - Country:US
Mailing Address - Phone:847-918-8282
Mailing Address - Fax:847-240-2418
Practice Address - Street 1:3 HAWTHORN PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1446
Practice Address - Country:US
Practice Address - Phone:847-918-8282
Practice Address - Fax:847-918-8215
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490014251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
08838OtherMANAGED HEALTH NETWORK
IL207844OtherGROUP MEDICARE NUMBER
IL1633897OtherBCBS GROUP PROVIDER NUMBER
IL32-0084889OtherGROUP TAX ID NUMBER