Provider Demographics
NPI:1295593952
Name:STEPTER, RAVEN
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:STEPTER
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 1:8657 S KOLIN AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-3538
Mailing Address - Country:US
Mailing Address - Phone:309-992-8944
Mailing Address - Fax:
Practice Address - Street 1:600 HOLIDAY PLAZA DR STE 530
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2238
Practice Address - Country:US
Practice Address - Phone:219-775-4271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst