Healthcare Provider Details

I. General information

NPI: 1295643880
Provider Name (Legal Business Name): ELVIA VELAZQUEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 PRESTON AVE
ELGIN IL
60120-2467
US

IV. Provider business mailing address

1150 PRESTON AVE
ELGIN IL
60120-2467
US

V. Phone/Fax

Practice location:
  • Phone: 773-552-2156
  • Fax:
Mailing address:
  • Phone: 773-552-2156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.012215
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: