Provider Demographics
NPI:1245936905
Name:WAKA, RAHILA
Entity type:Individual
Prefix:
First Name:RAHILA
Middle Name:
Last Name:WAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S INDIANA AVE APT 808
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2772
Mailing Address - Country:US
Mailing Address - Phone:773-999-3300
Mailing Address - Fax:
Practice Address - Street 1:1210 S INDIANA AVE APT 808
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2772
Practice Address - Country:US
Practice Address - Phone:773-999-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health