Provider Demographics
NPI:1982236121
Name:SUMMIT BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:SUMMIT BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAHZARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-552-0325
Mailing Address - Street 1:6253 S ARCHER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:IL
Mailing Address - Zip Code:60501-1718
Mailing Address - Country:US
Mailing Address - Phone:708-552-0325
Mailing Address - Fax:
Practice Address - Street 1:6253 S ARCHER RD
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:IL
Practice Address - Zip Code:60501-1718
Practice Address - Country:US
Practice Address - Phone:708-552-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty