1942399787 NPI number — MISS RISE MICHELE MCELHENNEY MA CCCSLP

Table of content: MISS RISE MICHELE MCELHENNEY MA CCCSLP (NPI 1942399787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942399787 NPI number — MISS RISE MICHELE MCELHENNEY MA CCCSLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCELHENNEY
Provider First Name:
RISE
Provider Middle Name:
MICHELE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MA CCCSLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942399787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24979 WEST ORCHARD PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROUND LAKE HEIGHTS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60073
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-546-5093
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41412 N HIGHWAY 83 STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANTIOCH
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60002-1907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-989-2276
Provider Business Practice Location Address Fax Number:
224-707-0131
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  146006435 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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