Provider Demographics
NPI:1124460225
Name:ZACHREL, ELAINE (MA)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:ZACHREL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W OLD NORTHWEST HWY
Mailing Address - Street 2:SUITE 190
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6811
Mailing Address - Country:US
Mailing Address - Phone:224-633-9685
Mailing Address - Fax:
Practice Address - Street 1:509 W OLD NORTHWEST HWY
Practice Address - Street 2:SUITE 190
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6811
Practice Address - Country:US
Practice Address - Phone:224-633-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional