Provider Demographics
NPI:1811551427
Name:RAKAR, STEPHAN JOHN (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHAN
Middle Name:JOHN
Last Name:RAKAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 ESSINGTON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8447
Mailing Address - Country:US
Mailing Address - Phone:815-823-8460
Mailing Address - Fax:
Practice Address - Street 1:1150 ESSINGTON RD STE 101
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8447
Practice Address - Country:US
Practice Address - Phone:815-823-8460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty