Provider Demographics
NPI:1740511211
Name:EWS OF ILLINOIS INC.
Entity type:Organization
Organization Name:EWS OF ILLINOIS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:SENKPEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-651-8489
Mailing Address - Street 1:4709 KINGS WAY N
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3215
Mailing Address - Country:US
Mailing Address - Phone:847-651-8489
Mailing Address - Fax:
Practice Address - Street 1:34121 N US HIGHWAY 45
Practice Address - Street 2:SUITE 209
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1768
Practice Address - Country:US
Practice Address - Phone:847-651-8489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-23
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty