Individual
ELMYRA WALDEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LCPC
Contact information
Practice address
140 NORTH OAKWOOD AVE, WEST CHICAGO, IL 60185
(630) 881-2525
Mailing address
0 NORTH 479 MORNINGSIDE AVE, WEST CHICAGO, IL 60185
(630) 881-2525
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232460
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
04/05/2006
Last updated
07/08/2007
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