Provider Demographics
NPI:1558786442
Name:ELLIOTT, MONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 W WINONA ST APT 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2942
Mailing Address - Country:US
Mailing Address - Phone:312-217-0909
Mailing Address - Fax:
Practice Address - Street 1:1132 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1143
Practice Address - Country:US
Practice Address - Phone:847-866-6144
Practice Address - Fax:847-866-6233
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0126451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical