Elliott, Amanda Ray
Elliott, Amanda Ray is an sole proprietor health care provider with primary practice located at 1580 N Northwest Hwy Unit 215, Park Ridge IL 60068-1444. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Elliott, Amanda Ray can be contacted via phone (847) 299-3400.Contact Information
Primary practice address
1580 N Northwest Hwy Unit 215
Park Ridge IL 60068-1444
Phone: (847) 299-3400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1922324342 |
|---|---|
| LBN Legal business name | Elliott, Amanda Ray |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2010 |
| Last updated | May 28th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922324342 | NPPES |
| Illinois | MEDICAID | 475 |
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