Provider Demographics
NPI:1811320476
Name:SALINE, ELIZABETH S (LMT, BCTMB)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:S
Last Name:SALINE
Suffix:
Gender:F
Credentials:LMT, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N WILLISTON ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5848
Mailing Address - Country:US
Mailing Address - Phone:630-913-0813
Mailing Address - Fax:
Practice Address - Street 1:215 N WILLISTON ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5848
Practice Address - Country:US
Practice Address - Phone:630-913-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL012308225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist