Healthcare Provider Details

I. General information

NPI: 1245800523
Provider Name (Legal Business Name): BRIANNA KARA ELIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 W BELMONT AVE
CHICAGO IL
60657-4408
US

IV. Provider business mailing address

1657 HENLEY CT
WHEELING IL
60090-6910
US

V. Phone/Fax

Practice location:
  • Phone: 312-530-0323
  • Fax: 773-261-0929
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.032838
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: