Ellis Therapy & Fitness | |
16595 W Easton Ave Prairie View IL 60069-2744 | |
(847) 242-1669 | |
(815) 524-2271 |
Full Name | Ellis Therapy & Fitness |
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Speciality | Social Worker - Clinical |
Location | 16595 W Easton Ave, Prairie View, Illinois |
Authorized Official Name and Position | Debra Ellis (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 8472421669 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ellis Therapy & Fitness 16595 W Easton Ave Prairie View IL 60069-2744 Ph: (847) 242-1669 | Ellis Therapy & Fitness 16595 W Easton Ave Prairie View IL 60069-2744 Ph: (847) 242-1669 |
NPI Number | 1548674203 |
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Provider Enumeration Date | 06/19/2014 |
Last Update Date | 06/19/2014 |
Identifier | Type | State | Issuer |
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1548674203 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 149013439 (Illinois) | Primary |