Provider Demographics
NPI:1811166143
Name:TONI REY,LCSW,LTD.
Entity type:Organization
Organization Name:TONI REY,LCSW,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:STAPLEY
Authorized Official - Last Name:REY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-847-7644
Mailing Address - Street 1:18 E HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3076
Mailing Address - Country:US
Mailing Address - Phone:847-847-7644
Mailing Address - Fax:
Practice Address - Street 1:18 E HARBOR DR
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3076
Practice Address - Country:US
Practice Address - Phone:847-847-7644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR16831Medicare UPIN
IL208099Medicare PIN