Healthcare Provider Details

I. General information

NPI: 1427915883
Provider Name (Legal Business Name): MIDWEST SHELTER FOR HOMELESS VETERANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 S CARLTON AVE
WHEATON IL
60187-4872
US

IV. Provider business mailing address

433 S CARLTON AVE
WHEATON IL
60187-4872
US

V. Phone/Fax

Practice location:
  • Phone: 630-871-8387
  • Fax: 630-653-6748
Mailing address:
  • Phone: 630-871-8387
  • Fax: 630-653-6748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN ELLEN LLOYD
Title or Position: CREDENTIALER
Credential: CMA, CFE, CPC
Phone: 854-218-4644