Provider Demographics
NPI:1770735763
Name:PILICY, ELIZABETH H (BA, BS, DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:H
Last Name:PILICY
Suffix:
Gender:F
Credentials:BA, BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14673 MIDWAY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3950
Mailing Address - Country:US
Mailing Address - Phone:978-846-1964
Mailing Address - Fax:
Practice Address - Street 1:14673 MIDWAY RD STE 105
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3950
Practice Address - Country:US
Practice Address - Phone:978-846-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3209111N00000X, 111NN1001X, 111NS0005X
TX11413111N00000X, 111NP0017X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11413OtherTEXAS STATE CHIROPRACTIC LICENSE NUMBER
MA3209OtherMA STATE CHIROPRACTIC LICENSE NUMBER