Provider Demographics
NPI:1326751694
Name:RUBIN, RINA S (LSW)
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:S
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6337 N MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1209
Mailing Address - Country:US
Mailing Address - Phone:773-818-9976
Mailing Address - Fax:
Practice Address - Street 1:3545 LAKE AVE STE 200
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1058
Practice Address - Country:US
Practice Address - Phone:847-386-6560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150110509104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker