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

Table of Contents

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".




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