Provider Demographics
NPI:1750033569
Name:OAK AND ELM COLLECTIVE THERAPY PLLC
Entity Type:Organization
Organization Name:OAK AND ELM COLLECTIVE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:847-826-0757
Mailing Address - Street 1:10457 DORCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4238
Mailing Address - Country:US
Mailing Address - Phone:847-826-0757
Mailing Address - Fax:
Practice Address - Street 1:516 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5175
Practice Address - Country:US
Practice Address - Phone:847-826-0757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center