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Organization

ELLIS THERAPY & FITNESS

Active
Other names
Debra Ellis Therapy Services
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBRA ELLIS LCSW (LICENSED CLINICAL SOCIAL WORKER)
(847) 242-1669
Entity
Organization

Contact information

Practice address
16595 W EASTON AVE, PRAIRIE VIEW, IL 60069-2744
(847) 242-1669
(815) 524-2271
Mailing address
16595 W EASTON AVE, PRAIRIE VIEW, IL 60069-2744
(847) 242-1669
(815) 524-2271

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013439
IL

Other

Enumeration date
06/19/2014
Last updated
06/19/2014
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