Individual
ELLEN R BLUMENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
435 GROVE ST, GLENCOE, IL 60022-1845
(847) 707-2135
Mailing address
435 GROVE ST, GLENCOE, IL 60022-1845
(847) 707-2135
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150-003336
IL
1041C0700X
Clinical Social Worker
Primary
149.019809
IL
Other
Enumeration date
11/04/2011
Last updated
03/06/2018
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