Individual
ELENA RUTA TIJUNELIS HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6918 WINDSOR AVE, BERWYN, IL 60402-3334
(708) 795-4800
Mailing address
2908 S EMERALD AVE, CHICAGO, IL 60616-3009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.012246
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K45105
MEDICARE B
IL
Enumeration date
03/07/2007
Last updated
11/02/2007
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