Individual
MS. AMANDA RAY ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1580 N NORTHWEST HWY, UNIT 215, PARK RIDGE, IL 60068-1444
(847) 299-3400
Mailing address
1211 EVERGREEN AVE, DES PLAINES, IL 60016
(773) 699-8868
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475
—
IL
Enumeration date
04/09/2010
Last updated
05/28/2015
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