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General NPI Number Information
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NPI Number | 1164811196
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Entity Type | Organization
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Legal Business Name | ELITE PERFORMANCE COUNSELING, LLC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 101 N WASHINGTON ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-4511
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Country | US
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Telephone | 630-800-2432
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 N 123RD TER
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City | KANSAS CITY
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State | KS
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Zip | 66109-4561
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Country | US
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Telephone | 630-215-8211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN CHOQUETTE
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Credential | PSYD
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Telephone | 630-215-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180007168
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License Number State | IL
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