1790948321 NPI number — DONNA RATTE', PHD, LCSW, LLC

Table of content: (NPI 1790948321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790948321 NPI number — DONNA RATTE', PHD, LCSW, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONNA RATTE', PHD, LCSW, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DONNA RATTE', LCSW, LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790948321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1570 ELMWOOD AVE UNIT 809
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANSTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60201-4577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-840-3493
Provider Business Mailing Address Fax Number:
847-475-8350

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4433 W TOUHY AVE STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLNWOOD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60712-1838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-840-3493
Provider Business Practice Location Address Fax Number:
847-475-8350
Provider Enumeration Date:
07/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RATTE
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
LICENSED CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
847-840-3493

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149009375 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04932146 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com