Individual
AMY LU ANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 N HIGHLAND AVE, AURORA, IL 60506-1449
(630) 906-7015
Mailing address
1820 S 25TH AVE, BROADVIEW, IL 60155-3960
(708) 681-0073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YM0800X
IL
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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