Provider Demographics
NPI:1407928708
Name:WELLS, JOAN ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ELIZABETH
Last Name:WELLS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SPRING RD
Mailing Address - Street 2:STE 215
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1350
Mailing Address - Country:US
Mailing Address - Phone:847-394-4539
Mailing Address - Fax:
Practice Address - Street 1:1550 SPRING RD
Practice Address - Street 2:STE 215
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1350
Practice Address - Country:US
Practice Address - Phone:847-394-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149002391104100000X
IL149-002391104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker