Most Relevant Information
Provider Data
| NPI Number: | 1003395831 |
| Provider Name: | KEVIN JOSEPH ELLIOTT |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 149022425 |
Most Important Dates
| Enumeration Date: | 08/13/2018 |
| Last Updated: | 04/30/2021 |
Provider Practice Location
1807 S NEIL ST
CHAMPAIGN
IL
618207215
Practice Location Phone/Fax
| Phone: | 8158785078 |
| Fax: |
Provider Mailing Location
1807 S NEIL ST
CHAMPAIGN
IL
618207215
Provider Mailing Phone/Fax
| Phone: | 8158785078 |
| Fax: |