Organization
ELITE IMPACT LLC
Active
Organization
ELITE IMPACT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE FRAZIER (OWNER)
(708) 466-9716
Entity
Organization
Contact information
Practice address
7610 S MAY ST. APT.1, CHICAGO, IL 60620
(708) 466-9716
Mailing address
10735 S WESTERN AVE, STE 6 #234, CHICAGO, IL 60643
(708) 466-9716
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
152W00000X
Optometrist
—
—
163WP0200X
Pediatric Registered Nurse
—
—
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
07/08/2026
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