Provider Demographics
NPI:1467778357
Name:AMOROSO, ELIZABETH MARY (PT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARY
Last Name:AMOROSO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 N CLARK ST
Mailing Address - Street 2:#2504
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5301
Mailing Address - Country:US
Mailing Address - Phone:312-343-0235
Mailing Address - Fax:
Practice Address - Street 1:1850 N CLARK ST
Practice Address - Street 2:#2504
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5301
Practice Address - Country:US
Practice Address - Phone:312-343-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700148752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic