Provider Demographics
NPI:1346397874
Name:CONNER, ELIZABETH L (PHD CCC SLP)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:L
Last Name:CONNER
Suffix:
Gender:F
Credentials:PHD CCC SLP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:TROESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD CCC SLP
Mailing Address - Street 1:14619 SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62014-3127
Mailing Address - Country:US
Mailing Address - Phone:813-390-9109
Mailing Address - Fax:
Practice Address - Street 1:14619 SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IL
Practice Address - Zip Code:62014-3127
Practice Address - Country:US
Practice Address - Phone:217-730-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8005235Z00000X
235Z00000X
IL146.003768235Z00000X
WI2751154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN533G2TEOtherBCBS