David Elliott
Individual provider Active NPI Counselor · Anna, IL
NPI 1295401271 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1295401271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 800 N Main St
Anna, IL 62906-1665 - Phone
- (618) 833-4456
- Fax
- (618) 833-2371
- NPI assigned
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
800 N Main St
Anna, IL 62906-1665
Mailing address
902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483
Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.