Individual
ELLEN LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N WOLF RD, NORTHLAKE, IL 60164-1438
(847) 644-0896
Mailing address
1005 MEADOW LN, ELGIN, IL 60123-1429
(847) 644-0896
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
149-004535
IL
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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