Provider Demographics
NPI:1831912997
Name:MIHEVC, ELIZABETH MIHEVC (MA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MIHEVC
Last Name:MIHEVC
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 N WESTGATE RD APT 102
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2663
Mailing Address - Country:US
Mailing Address - Phone:630-205-4657
Mailing Address - Fax:
Practice Address - Street 1:290 N WESTGATE RD APT 102
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2663
Practice Address - Country:US
Practice Address - Phone:630-205-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.001802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist