Provider Demographics
NPI:1013386036
Name:RATHBUN-MCVEIGH, HEIDI LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNN
Last Name:RATHBUN-MCVEIGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S PAULINA ST STE 251
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3206
Mailing Address - Country:US
Mailing Address - Phone:312-563-4630
Mailing Address - Fax:
Practice Address - Street 1:325 S PAULINA ST STE 251
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3206
Practice Address - Country:US
Practice Address - Phone:312-563-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX610091041C0700X
IL149.0212531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical