| Ellis Therapy & Fitness | |
|
16595 W Easton Ave Prairie View IL 60069-2744 | |
| (847) 242-1669 | |
| (815) 524-2271 |
| Full Name | Ellis Therapy & Fitness |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 06/19/2014 |
| Last Update Date | 06/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548674203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149013439 (Illinois) | Primary |