Provider Demographics
NPI:1508007337
Name:KARIM, ELBA JUNG (MA)
Entity Type:Individual
Prefix:
First Name:ELBA
Middle Name:JUNG
Last Name:KARIM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36W830 WOODLAND CT
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4946
Mailing Address - Country:US
Mailing Address - Phone:630-408-2170
Mailing Address - Fax:630-584-4618
Practice Address - Street 1:36W830 WOODLAND CT
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4946
Practice Address - Country:US
Practice Address - Phone:630-408-2170
Practice Address - Fax:630-584-4618
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180000322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional