Individual ProviderElizabeth H FungSocial WorkerBehavioral Health & Social Service ProvidersPractice Address2524 N Lincoln Ave, Lincoln Park Psychological Associate - Suite J, Chicago, IL 60614-2473(773) 477-0584PECOS EnrollmentBased on the most recent information from CMS, provider Elizabeth H Fung does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1972623585Provider TypeIndividualFull NameFung, Elizabeth HCredentialPH.D.GenderFemaleSole ProprietorYesEnumeration Date3/29/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address2524 N Lincoln Ave, Lincoln Park Psychological Associate - Suite J, Chicago, IL 60614-2473Phone(773) 477-0584Fax(773) 477-0584Mailing LocationMailing Address421 W Webster Ave, Chicago, IL 60614-3812Phone(773) 477-0584FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.001352IllinoisProvider IdentifiersIDDescriptionIssuerID149.001352DescriptionOtherIssuerLCSWIllinois