Provider Demographics
NPI:1609829159
Name:REBECCA FLORES, INC.
Entity Type:Organization
Organization Name:REBECCA FLORES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-268-1339
Mailing Address - Street 1:3816 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-4014
Mailing Address - Country:US
Mailing Address - Phone:708-749-7640
Mailing Address - Fax:708-749-7642
Practice Address - Street 1:3816 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-4014
Practice Address - Country:US
Practice Address - Phone:708-749-7640
Practice Address - Fax:708-749-7642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare