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General NPI Number Information
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NPI Number | 1982237426
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Entity Type | Individual
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Provider Name | ELOM TOGBI-WONYO
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Gender | Male
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 29W522 BATAVIA RD
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City | WARRENVILLE
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State | IL
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Zip | 60555-2007
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Country | US
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Telephone | 630-456-6167
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Fax |
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Provider Business Mailing Address
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Address Line | 2S726 GROVE LN
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City | WARRENVILLE
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State | IL
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Zip | 60555-2713
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Country | US
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Telephone | 630-456-6167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 180009704
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License Number State | IL
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