Provider Demographics
NPI:1609618669
Name:EL-TALABANI, KEATON JAMES (LCSW)
Entity type:Individual
Prefix:
First Name:KEATON
Middle Name:JAMES
Last Name:EL-TALABANI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 RACCOON CIR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-9330
Mailing Address - Country:US
Mailing Address - Phone:815-592-8193
Mailing Address - Fax:
Practice Address - Street 1:1600 GOLD RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-4263
Practice Address - Country:US
Practice Address - Phone:847-220-7629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0268881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical