Healthcare Provider Details

I. General information

NPI: 1831011915
Provider Name (Legal Business Name): ELISABETH FLORENCE KLEIN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

848 W EASTMAN ST STE 103
CHICAGO IL
60642-2635
US

IV. Provider business mailing address

848 W EASTMAN ST STE 103
CHICAGO IL
60642-2635
US

V. Phone/Fax

Practice location:
  • Phone: 312-702-2303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150.118919
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: