Provider Demographics
NPI:1356339931
Name:RAK, PAMELA (MSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:RAK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:RAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2500 W HIGGINS RD STE 1143
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7239
Mailing Address - Country:US
Mailing Address - Phone:847-776-1594
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD STE 1143
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7239
Practice Address - Country:US
Practice Address - Phone:847-776-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490079831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212241Medicare UPIN