Provider Demographics
NPI:1356528830
Name:TAMULEWICZ, ELIZABETH ANN (DT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:TAMULEWICZ
Suffix:
Gender:F
Credentials:DT
Other - Prefix:MRS
Other - First Name:EIZABETH
Other - Middle Name:ANN
Other - Last Name:BOHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DT
Mailing Address - Street 1:1441 COLUMBUS DR
Mailing Address - Street 2:1441 COLUMBUS DR
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-1409
Mailing Address - Country:US
Mailing Address - Phone:630-476-2075
Mailing Address - Fax:
Practice Address - Street 1:1441 COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-1409
Practice Address - Country:US
Practice Address - Phone:630-476-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-27
Last Update Date:2008-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist