Provider Demographics
NPI:1962284604
Name:TOVAR, ARIELLE (LSW)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:TOVAR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 REMINGTON BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-3663
Mailing Address - Country:US
Mailing Address - Phone:630-410-9578
Mailing Address - Fax:630-296-0749
Practice Address - Street 1:215 REMINGTON BLVD STE G
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3663
Practice Address - Country:US
Practice Address - Phone:630-410-9578
Practice Address - Fax:630-296-0749
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.110582104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker