Healthcare Provider Details

I. General information

NPI: 1225478209
Provider Name (Legal Business Name): COREXCELLENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 S WASHINGTON ST STE 170
NAPERVILLE IL
60565-6377
US

IV. Provider business mailing address

2603 S WASHINGTON ST STE 170
NAPERVILLE IL
60565-6377
US

V. Phone/Fax

Practice location:
  • Phone: 331-472-7132
  • Fax: 630-282-0427
Mailing address:
  • Phone: 331-472-7132
  • Fax: 630-282-0427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLA ORDONEZ
Title or Position: OWNER/THERAPIST
Credential: PH.D., LMFT, EDS.
Phone: 630-567-7215