Provider Demographics
NPI:1922531425
Name:EWING-ELIAS, ALLISON (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:EWING-ELIAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1521 BUCKINGHAM GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1554
Mailing Address - Country:US
Mailing Address - Phone:773-742-3432
Mailing Address - Fax:
Practice Address - Street 1:1521 BUCKINGHAM GLEN CIR
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1554
Practice Address - Country:US
Practice Address - Phone:773-742-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490094341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical