Provider Demographics
NPI:1497344345
Name:REBECCA ISRAILEVICH LLC
Entity Type:Organization
Organization Name:REBECCA ISRAILEVICH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISRAILEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-224-3880
Mailing Address - Street 1:4429 N WINCHESTER AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5847
Mailing Address - Country:US
Mailing Address - Phone:847-224-3880
Mailing Address - Fax:
Practice Address - Street 1:4429 N WINCHESTER AVE APT 2B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5847
Practice Address - Country:US
Practice Address - Phone:847-224-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty