Provider Demographics
NPI:1588386569
Name:KOHN, ELIANA
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:KOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 W NORTH AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1623
Mailing Address - Country:US
Mailing Address - Phone:847-329-9210
Mailing Address - Fax:773-347-2656
Practice Address - Street 1:191 WAUKEGAN RD STE 208
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2743
Practice Address - Country:US
Practice Address - Phone:847-329-9210
Practice Address - Fax:773-347-2656
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional