Provider Demographics
NPI:1225618408
Name:MARANTO, ELIZABETH MAE
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MAE
Last Name:MARANTO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:MAE
Other - Last Name:BOREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18W161 BUCKINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3821
Mailing Address - Country:US
Mailing Address - Phone:630-487-1437
Mailing Address - Fax:
Practice Address - Street 1:2269 N KEDZIE BLVD APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2591
Practice Address - Country:US
Practice Address - Phone:312-819-7381
Practice Address - Fax:312-428-3093
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health