Individual provider · Type 1 NPI

Ellamonique Baccus

Professional Counselor · South Holland, IL

NPI number 1710227145 Active

Practice location

16107 Lasalle Street
South Holland, IL 60473

Call (800) 361-6880 Map

Fax (708) 845-5505

Mailing address

15127 S 73rd Ave, Suite G
Orland Park, IL 60462-4398

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X180007887 (IL)

Professional Counselor: Definition to come...

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About NPI 1710227145

Ellamonique Baccus's National Provider Identifier is 1710227145, issued on Feb 21, 2013. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in South Holland, IL. The record was last updated on Feb 21, 2013.