Provider Demographics
NPI:1013442334
Name:SALTZMAN, ELIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIE
Middle Name:
Last Name:SALTZMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 DUNDEE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2726
Mailing Address - Country:US
Mailing Address - Phone:847-656-5080
Mailing Address - Fax:
Practice Address - Street 1:666 DUNDEE RD STE 305
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2726
Practice Address - Country:US
Practice Address - Phone:847-656-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical