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General NPI Number Information
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NPI Number | 1932221181
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Entity Type | Organization
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Legal Business Name | PATRICIA ELY AND ASSOCIATES
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 2625 BUTTERFIELD ROAD SUITE 103W
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City | OAK BROOK
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State | IL
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Zip | 60523
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Country | US
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Telephone | 630-574-9000
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Fax | 630-574-9277
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Provider Business Mailing Address
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Address Line | 2625 BUTTERFIELD ROAD SUITE 103W
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City | OAK BROOK
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State | IL
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Zip | 60523
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Country | US
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Telephone | 630-574-9000
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Fax | 630-574-9277
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Authorized Official
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Title or Position | OWNER/SOCIAL WORKER/CLINICAL DIRECT
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Name | MS. PATRICIA JOAN ELY
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Credential | MSW, LCSW, ACSW
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Telephone | 630-574-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 149.005969
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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