Provider Demographics
NPI:1710503982
Name:ELEVATE HOUSING FOUNDATION
Entity Type:Organization
Organization Name:ELEVATE HOUSING FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-414-3847
Mailing Address - Street 1:7101 N CICERO AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2112
Mailing Address - Country:US
Mailing Address - Phone:224-420-7133
Mailing Address - Fax:
Practice Address - Street 1:405 E 5TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-5705
Practice Address - Country:US
Practice Address - Phone:833-370-0719
Practice Address - Fax:515-220-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)