Provider Demographics
NPI:1699846857
Name:LENNARD, ELISE F (MA)
Entity type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:F
Last Name:LENNARD
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 1:2023 N FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4311
Mailing Address - Country:US
Mailing Address - Phone:773-244-1036
Mailing Address - Fax:773-244-1037
Practice Address - Street 1:2023 N FREMONT ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4311
Practice Address - Country:US
Practice Address - Phone:773-244-1036
Practice Address - Fax:773-244-1037
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0010981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149-001098OtherLCSW