Provider Demographics
NPI:1851829394
Name:ELKHATIB, LENA (MA)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:ELKHATIB
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LENA
Other - Middle Name:
Other - Last Name:ELKHATIB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LENA ELKHATIB
Mailing Address - Street 1:939 W NORTH AVE STE 750
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-7142
Mailing Address - Country:US
Mailing Address - Phone:419-376-1587
Mailing Address - Fax:
Practice Address - Street 1:939 W NORTH AVE STE 750
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-7142
Practice Address - Country:US
Practice Address - Phone:312-600-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist