Healthcare Provider Details

I. General information

NPI: 1710787064
Provider Name (Legal Business Name): ELEANOR WINDLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 W 63RD ST
SUMMIT IL
60501-1816
US

IV. Provider business mailing address

600 W FULTON ST STE 300
CHICAGO IL
60661-1259
US

V. Phone/Fax

Practice location:
  • Phone: 708-458-0757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.028394
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: