Healthcare Provider Details

I. General information

NPI: 1356031363
Provider Name (Legal Business Name): EMOTIONAL INTELLIGENCE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2624 N 77TH CT
ELMWOOD PARK IL
60707-1801
US

IV. Provider business mailing address

P.O. BOX 35309
ELMWOOD PARK IL
60707
US

V. Phone/Fax

Practice location:
  • Phone: 773-991-6187
  • Fax: 855-222-5962
Mailing address:
  • Phone: 773-991-6187
  • Fax: 855-222-5962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TRACY L COOPER
Title or Position: CEO/OWNER
Credential: MSW, LCSW, EI-I/ECMH
Phone: 773-991-6187