Provider Demographics
NPI:1790574424
Name:ELLEN LONNQUIST PLLC
Entity type:Organization
Organization Name:ELLEN LONNQUIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONNQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:847-814-1734
Mailing Address - Street 1:1740 RIDGE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-5909
Mailing Address - Country:US
Mailing Address - Phone:847-814-1734
Mailing Address - Fax:847-475-7333
Practice Address - Street 1:1740 RIDGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5909
Practice Address - Country:US
Practice Address - Phone:847-814-1734
Practice Address - Fax:847-475-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty