MEDICARE: ELEVARE IN ILLINOIS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	104100000X	Social Worker
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1518800101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVARE IN ILLINOIS, PLLC

Provider Business Mailing Address
First Line	:	111 N WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:	317-563-1117
Fax Number	:	317-608-3436

Provider Business Practice Location Address
First Line	:	111 N WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:	317-563-1117
Fax Number	:	317-608-3436

Authorized Official
Title or Position	:	CO-OWNER
Name	:	CHANTEL WHITE
Credential	:	LCSW
Telephone Number	:	317-563-1117

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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