Provider Demographics
NPI:1164627337
Name:STARZEC, ELIZABETH (MED, MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:STARZEC
Suffix:
Gender:F
Credentials:MED, MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W CAMBRIA DR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-3213
Mailing Address - Country:US
Mailing Address - Phone:847-409-4332
Mailing Address - Fax:815-301-9878
Practice Address - Street 1:409 W CAMBRIA DR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-3213
Practice Address - Country:US
Practice Address - Phone:847-409-4332
Practice Address - Fax:815-301-9878
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL056.011849225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist