ELISABETH AV DESAPEREIRA,MD,LTD (NPI# 1578648408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578648408 |
| Entity Type | Organization |
| Organization Name | ELISABETH AV DESAPEREIRA,MD,LTD |
| Practice Address |
1117 S Milwaukee Ave Suite B8 Libertyville IL 60048-3798 |
| Mailing Address |
3018 Parkside Dr Highland Park IL 60035-1067 |
| Practice Telephone | 8472819990 |
| Practice Fax Number | 8472950293 |
| Mailing Telephone | 8474330057 |
| Mailing Fax Number | 8474322174 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-08-08 |
| Authorized Official Name | ELISABETH A V DESAPEREIRA (PRESIDENT) |
| Authorized Official Telephone | 8473895930 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036049974 | 05 |
| Street Address |
1117 S MILWAUKEE AVE SUITE B8 |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-3798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679549661 | Oksana Mensheha | Ophthalmology | 1117 S Milwaukee Ave, Forum Square A-10, Libertyville, IL 60048-3798 | 2006-02-28 |
| 1437494796 | Buda Health Services, Inc. | In Home Supportive Care | 1117 S Milwaukee Ave, Suite B-3, Libertyville, IL 60048-3798 | 2012-11-27 |
| 1225386972 | North Shore Physical Medical Group, Sc | Anesthesiology | 1117 S Milwaukee Ave, Suite D-7, Libertyville, IL 60048-3798 | 2012-08-28 |
| 1023395381 | Provida Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 1117 S Milwaukee Ave, Suite D 5, Libertyville, IL 60048-5257 | 2011-11-14 |
| 1407081599 | Walter P Duzey Dc PC | Chiropractor | 1117 S Milwaukee Ave, D-7, Libertyville, IL 60048-3798 | 2009-05-19 |
| 1255534137 | Oksana Mensheha, M.d., S.c. | Eyewear Supplier (Equipment, not the service) | 1117 S Milwaukee Ave, Forum Square A-10, Libertyville, IL 60048-3798 | 2007-06-07 |
| 1851431571 | Oksana Mensheha, M.d., S.c. | Optometrist | 1117 S Milwaukee Ave, Forum Square A-10, Libertyville, IL 60048-3798 | 2007-02-08 |
| 1477638948 | Michael L Klestinski & Associates, P.C. | Social Worker | 1117 S Milwaukee Ave, Forum Square Building B Suite 2, Libertyville, IL 60048-3798 | 2006-10-25 |
| 1093824161 | Michael L Klestinki Acsw & Associates P.C. | Social Worker | 1117 S Milwaukee Ave, Forum Square Bldg B Ste 2, Libertyville, IL 60048-3798 | 2006-08-30 |
| 1164538302 | Walter Philip Duzey | Chiropractor | 1117 S Milwaukee Ave, Suite D7, Libertyville, IL 60048 | 2006-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871695932 | Shazia Tayyab | Psychiatry & Neurology | 31480 N Us Highway 45, Libertyville, IL 60048-9444 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144851684 | Greywood Health Center LLC | Psychiatry & Neurology | 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 | 2020-02-03 |
| 1285273540 | Tms Clinical Services Pllc | Psychiatry & Neurology | 1100 Jorie Blvd Ste 172, Oak Brook, IL 60523-4409 | 2020-01-03 |
| 1942702386 | Brain and Wellness Institute LLC | Psychiatry & Neurology | 30 W Oak St Apt 14a, Chicago, IL 60610-8724 | 2018-03-01 |
| 1598278749 | Elemental Treatment Center Ltd | Psychiatry & Neurology | 612 S Western Ave Apt 1, Chicago, IL 60612-4682 | 2017-11-09 |
| 1225404551 | Family Renewed, LLC | Psychiatry & Neurology | 1004 Pebble Beach Dr, Caseyville, IL 62232-2834 | 2015-08-21 |
| 1487032082 | Jerry Francisco Benzl | Psychiatry & Neurology | 1740 Taylor St., Chicago, IL 60612 | 2015-05-14 |
| 1942697800 | Dr Mo S.c | Psychiatry & Neurology | 2131 W Silverleaf Ln, Addison, IL 60101-6404 | 2015-04-17 |
| 1104234046 | Hitekshya Nepal | Psychiatry & Neurology | 5230 6th Street Frontage Rd E, Springfield, IL 62703-5128 | 2014-07-23 |
| 1740558261 | Jyoti Shah | Psychiatry & Neurology | 1335 N Mill St Ste 100, Naperville, IL 60563-2047 | 2011-12-12 |
| 1083921530 | Jodi Chase | Psychiatry & Neurology | 480 Elm Pl Ste 106, Highland Park, IL 60035-2535 | 2010-09-04 |
| Find all providers with the same taxonomy | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.