Provider Demographics
NPI:1740004902
Name:MCELROY, MCKINLEY DANAE (RBT)
Entity type:Individual
Prefix:
First Name:MCKINLEY
Middle Name:DANAE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21226 OLD NORTH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3017
Mailing Address - Country:US
Mailing Address - Phone:708-606-0010
Mailing Address - Fax:
Practice Address - Street 1:21226 OLD NORTH CHURCH RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-3017
Practice Address - Country:US
Practice Address - Phone:708-606-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-24-367122106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician