Individual
DR. ELLIE LEDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53 W JACKSON BLVD STE 1301, CHICAGO, IL 60604-3552
(312) 884-1164
Mailing address
1929 W EVERGREEN AVE, CHICAGO, IL 60622-2471
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071010170
IL
Other
Enumeration date
12/30/2019
Last updated
01/02/2020
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