Provider Demographics
NPI:1497863583
Name:RATHNOW, STEPHEN J (MA LCPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:RATHNOW
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Gender:M
Credentials:MA LCPC
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Mailing Address - Street 1:1770 E LAKE SHORE DR
Mailing Address - Street 2:STE 209
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521
Mailing Address - Country:US
Mailing Address - Phone:217-428-0600
Mailing Address - Fax:217-423-6536
Practice Address - Street 1:1770 E LAKE SHORE DR
Practice Address - Street 2:STE 209
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521
Practice Address - Country:US
Practice Address - Phone:217-428-0600
Practice Address - Fax:217-423-6536
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry