Healthcare Provider Details

I. General information

NPI: 1982180626
Provider Name (Legal Business Name): ARIELLE JANEE FELTUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 PEARL ST
AURORA IL
60505-4519
US

IV. Provider business mailing address

4201 178TH ST
COUNTRY CLUB HILLS IL
60478-7013
US

V. Phone/Fax

Practice location:
  • Phone: 630-966-4492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: