Healthcare Provider Details

I. General information

NPI: 1174115315
Provider Name (Legal Business Name): CAMILLA PHILIPPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N WOLF RD
WHEELING IL
60090-2924
US

IV. Provider business mailing address

33 WHEELING AVE
WHEELING IL
60090-3137
US

V. Phone/Fax

Practice location:
  • Phone: 847-260-7954
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.023561
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: