Provider Demographics
NPI:1902835705
Name:RAHN, JULIA MICHELE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:MICHELE
Last Name:RAHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 N LINCOLN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3122
Mailing Address - Country:US
Mailing Address - Phone:773-281-8130
Mailing Address - Fax:773-281-7150
Practice Address - Street 1:3139 N LINCOLN AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3122
Practice Address - Country:US
Practice Address - Phone:773-281-8130
Practice Address - Fax:773-281-7150
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005837103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021623225OtherBC/BS PROVIDER NUMBER