Provider Demographics
NPI:1871154385
Name:WELDON, ELAINA M (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:M
Last Name:WELDON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 KEDZIE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2362
Mailing Address - Country:US
Mailing Address - Phone:518-332-8615
Mailing Address - Fax:
Practice Address - Street 1:1660 OAKTON PL
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2045
Practice Address - Country:US
Practice Address - Phone:847-299-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-016507235Z00000X
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist