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Contact Information

ELEMENTAL CENTER LTD.
14484 JOHN HUMPHREY DR
ORLAND PARK, IL60462-2638
 Phone: 708-364-0580
 Fax: 708-364-0480
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Adolescent and Children Mental Health

261QM0855X
 

Adult Mental Health

261QM0850X
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for ELEMENTAL CENTER LTD · (Female)

NPI # 1033410477
Status Active
Credentials
Entity Individual
Enumeration date 11/16/2010
Last updated 10/22/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 036103889
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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