Provider Demographics
NPI:1669550240
Name:OLIVARES, ELIA (MS, CCC)
Entity type:Individual
Prefix:MRS
First Name:ELIA
Middle Name:
Last Name:OLIVARES
Suffix:
Gender:
Credentials:MS, CCC
Other - Prefix:MS
Other - First Name:ELIA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC
Mailing Address - Street 1:14200 S ROUTE 30 UNIT 100
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1067
Mailing Address - Country:US
Mailing Address - Phone:815-267-1260
Mailing Address - Fax:
Practice Address - Street 1:14200 S ROUTE 30 UNIT 100
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-1067
Practice Address - Country:US
Practice Address - Phone:815-267-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400099663Medicare PIN