Provider Demographics
NPI:1972077147
Name:MARKS, ILYSSA HOFFMAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ILYSSA
Middle Name:HOFFMAN
Last Name:MARKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ILYSSA
Other - Middle Name:RACHEL
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:121 S VAIL AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1854
Mailing Address - Country:US
Mailing Address - Phone:813-318-2120
Mailing Address - Fax:
Practice Address - Street 1:340 W BUTTERFIELD ROAD
Practice Address - Street 2:SUITE 4B
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:813-318-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-21
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0208721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical