Provider Demographics
NPI:1598860470
Name:STEFANGO, ELIANE GALVAO (LCPC)
Entity Type:Individual
Prefix:
First Name:ELIANE
Middle Name:GALVAO
Last Name:STEFANGO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD STE 138S
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1244
Mailing Address - Country:US
Mailing Address - Phone:773-979-4438
Mailing Address - Fax:630-528-3805
Practice Address - Street 1:2625 BUTTERFIELD RD STE 138S
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1244
Practice Address - Country:US
Practice Address - Phone:773-979-4438
Practice Address - Fax:630-528-3805
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-000798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional