Provider Demographics
NPI:1407904683
Name:RATTENBURY, FRANCINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCINE
Middle Name:
Last Name:RATTENBURY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 LAKE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1085
Mailing Address - Country:US
Mailing Address - Phone:708-386-7953
Mailing Address - Fax:
Practice Address - Street 1:1101 LAKE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1085
Practice Address - Country:US
Practice Address - Phone:708-386-7953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1673263OtherBLUE CROSS BLUE SHIELD