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NPI Code Detail

MEDICARE: ELLAINE COOPER-TAILLANDIER LSW

MEDICARE: ELLAINE COOPER-TAILLANDIER LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker150.114581IL

General Provider Information

NPI Number : 1215747662
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLAINE COOPER-TAILLANDIER LSW
Provider Business Mailing Address
First Line : 1917 SANDGATE CT
Second Line :
City : NAPERVILLE
State : IL
Zip : 60565-2306
Country : US
Telephone Number : 818-441-4756
Fax Number :
Provider Business Practice Location Address
First Line : 55 S MAIN ST STE 252
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-5576
Country : US
Telephone Number : 630-238-0949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2025
Last Update Date : 01/16/2025

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Directions to “ ELLAINE COOPER-TAILLANDIER LSW” Practice Location

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