Provider Demographics
NPI:1073265658
Name:RACHEL LONDON THERAPY PLLC
Entity Type:Organization
Organization Name:RACHEL LONDON THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-507-7572
Mailing Address - Street 1:3926 W TOUHY AVE # 181
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1028
Mailing Address - Country:US
Mailing Address - Phone:847-507-7572
Mailing Address - Fax:
Practice Address - Street 1:2930 W CHASE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-1214
Practice Address - Country:US
Practice Address - Phone:312-344-3883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty