Provider Demographics
NPI:1114065695
Name:ELAM, D FRANK (MSW)
Entity type:Individual
Prefix:MR
First Name:D
Middle Name:FRANK
Last Name:ELAM
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:FRANK
Other - Last Name:ELAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:56 SAUK TRL
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-2153
Mailing Address - Country:US
Mailing Address - Phone:708-805-7090
Mailing Address - Fax:
Practice Address - Street 1:3612 LINCOLN HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1627
Practice Address - Country:US
Practice Address - Phone:708-805-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical