Healthcare Provider Details

I. General information

NPI: 1518771682
Provider Name (Legal Business Name): ELLESE CALDERWOOD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 E RAND RD STE L109
ARLINGTON HEIGHTS IL
60004-4375
US

IV. Provider business mailing address

1845 E RAND RD
ARLINGTON HEIGHTS IL
60004-4356
US

V. Phone/Fax

Practice location:
  • Phone: 224-446-6101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178.021224
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: