Ellsworth, De'Juan

Ellsworth, De'Juan is an individual health care provider with primary practice located at 2310 W Roosevelt Rd , Chicago IL 60608-1131. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Ellsworth, De'Juan can be contacted via phone (312) 566-4500.

Contact Information

Primary practice address
2310 W Roosevelt Rd Chicago IL 60608-1131
Phone: (312) 566-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X Louisiana
Behavioral Health & Social Service Providers / Counselor 101Y00000X 362170821 Illinois
Other Service Providers / Case Manager/Care Coordinator 171M00000X Louisiana

Profile Details

NPI number 1467821587
LBN Legal business name Ellsworth, De'Juan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2015
Last updated May 11th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers