Provider Demographics
NPI:1396027579
Name:FOLAN, REBECCA M
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:M
Last Name:FOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6858 N NORTHWEST HWY
Mailing Address - Street 2:#3F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1258
Mailing Address - Country:US
Mailing Address - Phone:847-710-2196
Mailing Address - Fax:
Practice Address - Street 1:6858 N NORTHWEST HWY
Practice Address - Street 2:#3F
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1258
Practice Address - Country:US
Practice Address - Phone:847-710-2196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist