Provider Demographics
NPI:1740638915
Name:HARTMAN, ELIZABETH REGINA TUMINELLO (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:REGINA TUMINELLO
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:REGINA
Other - Last Name:TUMINELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1875 DEMPSTER ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1875 DEMPSTER ST STE 520
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1130
Practice Address - Country:US
Practice Address - Phone:847-720-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-29
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009302103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist