Provider Demographics
NPI:1497411771
Name:MUHS, SOMER RAE
Entity Type:Individual
Prefix:
First Name:SOMER
Middle Name:RAE
Last Name:MUHS
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 1:2104 W FOSTER AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1216
Mailing Address - Country:US
Mailing Address - Phone:765-438-4155
Mailing Address - Fax:
Practice Address - Street 1:1622 WILLOW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3441
Practice Address - Country:US
Practice Address - Phone:847-853-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004084A101YP2500X
IL180.014027101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional