Provider Demographics
NPI:1780715631
Name:MCELROY, MAGDALENA (LCSW)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:MCELROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E. WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60073
Mailing Address - Country:US
Mailing Address - Phone:847-377-8855
Mailing Address - Fax:847-546-0083
Practice Address - Street 1:423 E WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:ROUND LAKE PARK
Practice Address - State:IL
Practice Address - Zip Code:60073
Practice Address - Country:US
Practice Address - Phone:847-377-8855
Practice Address - Fax:847-546-0083
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0056241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149-005624OtherLICENSE