Provider Demographics
NPI:1881969541
Name:CONNIE B. NATVIG PH.D., PC
Entity type:Organization
Organization Name:CONNIE B. NATVIG PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:BEA
Authorized Official - Last Name:NATVIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-955-4950
Mailing Address - Street 1:477 E BUTTERFIELD ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:708-955-4950
Mailing Address - Fax:
Practice Address - Street 1:477 E BUTTERFIELD ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:708-955-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004997103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty