Individual
ELISA JULIA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, NBCC
Contact information
Practice address
6815 W 63RD ST STE 7, CHICAGO, IL 60638-4066
(708) 304-3010
(708) 575-5333
Mailing address
PO BOX 388556, CHICAGO, IL 60638-8556
(708) 304-3010
(708) 575-5333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178013267
IL
101YP2500X
Professional Counselor
Primary
180013779
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
IL
Enumeration date
05/19/2016
Last updated
03/27/2023
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