Provider Demographics
NPI:1174295901
Name:SARNO, ELISSA LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELISSA
Middle Name:LOUISE
Last Name:SARNO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 2400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4040
Mailing Address - Country:US
Mailing Address - Phone:872-231-2181
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 2400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4040
Practice Address - Country:US
Practice Address - Phone:773-609-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071010624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical