| Ellie Mental Health - Naperville | |
|
1804 N Naper Blvd Ste 250 Naperville IL 60563-8830 | |
| (708) 297-1723 | |
| Not Available |
| Full Name | Ellie Mental Health - Naperville |
|---|---|
| Speciality | Clinic/Center |
| Location | 1804 N Naper Blvd Ste 250, Naperville, Illinois |
| Authorized Official Name and Position | Elliotte G Lasley (OWNER) |
| Authorized Official Contact | 3124011428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health - Naperville 1804 N Naper Blvd Ste 250 Naperville IL 60563-8830 Ph: (708) 297-1723 | Ellie Mental Health - Naperville 1804 N Naper Blvd Ste 250 Naperville IL 60563-8830 Ph: (708) 297-1723 |
| NPI Number | 1477279651 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Medicare PECOS PAC ID | 6608231097 |
|---|---|
| Medicare Enrollment ID | O20230509001058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477279651 | NPI | - | NPPES |
| Provider Name | Denika S Mcmillen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174930077 PECOS PAC ID: 9335365147 Enrollment ID: I20140730001741 |
| Provider Name | Kristin A Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164959151 PECOS PAC ID: 5092105833 Enrollment ID: I20211222002460 |
| Provider Name | Brian Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336926393 PECOS PAC ID: 8022464239 Enrollment ID: I20231024003683 |
| Provider Name | Gloria Maria Tovar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437824257 PECOS PAC ID: 5799135018 Enrollment ID: I20231229000133 |
| Provider Name | Heather Michelle Olsson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316227440 PECOS PAC ID: 4880045467 Enrollment ID: I20240109002173 |
| Provider Name | Rucha B Shastri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508384611 PECOS PAC ID: 5496106965 Enrollment ID: I20240109002595 |
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