Provider Demographics
NPI:1497735922
Name:REITENBACH, CAROLINE A (MSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:REITENBACH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4152
Mailing Address - Country:US
Mailing Address - Phone:847-545-0400
Mailing Address - Fax:847-545-0405
Practice Address - Street 1:2025 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4152
Practice Address - Country:US
Practice Address - Phone:847-545-0400
Practice Address - Fax:847-545-0405
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL166283OtherVALUE OPTIONS
IL916294OtherFIRST HEALTH
IL1626146OtherBC/BS OF ILLINOIS
IL188409OtherCOMPSYCH
IL5519120OtherAETNA
IL916294OtherFIRST HEALTH