Provider Demographics
NPI:1609927292
Name:FRASER, ELIZABETH (OTR)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FRASER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CARRIAGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2205
Mailing Address - Country:US
Mailing Address - Phone:847-304-6650
Mailing Address - Fax:
Practice Address - Street 1:5073 SHORELINE RD
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1700
Practice Address - Country:US
Practice Address - Phone:847-842-0597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics