Provider Demographics
NPI:1619696143
Name:WINBORN, RACHEL MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:WINBORN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 N WHIPPLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4527
Mailing Address - Country:US
Mailing Address - Phone:917-971-2359
Mailing Address - Fax:
Practice Address - Street 1:201 E OGDEN AVE STE 118
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3776
Practice Address - Country:US
Practice Address - Phone:630-270-7717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108861104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker