| Rebecca Malley Lcpc, Pc | |
|
9007 W Cermak Rd North Riverside IL 60546-1017 | |
| (708) 522-4009 | |
| (630) 233-9332 |
| Full Name | Rebecca Malley Lcpc, Pc |
|---|---|
| Speciality | Counselor |
| Location | 9007 W Cermak Rd, North Riverside, Illinois |
| Authorized Official Name and Position | Rebecca Malley Fitzgerald (OWNER) |
| Authorized Official Contact | 7085224009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rebecca Malley Lcpc, Pc 9007 W Cermak Rd North Riverside IL 60546-1017 Ph: (708) 522-4009 | Rebecca Malley Lcpc, Pc 9007 W Cermak Rd North Riverside IL 60546-1017 Ph: (708) 522-4009 |
| NPI Number | 1619480019 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 07/02/2020 |
| Certification Date | 07/02/2020 |
| Medicare PECOS PAC ID | 7113360256 |
|---|---|
| Medicare Enrollment ID | O20240206002712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619480019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180007277 (Illinois) | Primary |
| Provider Name | Noel Cordova |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144685082 PECOS PAC ID: 1456794593 Enrollment ID: I20240206002847 |
| Provider Name | Rebecca Susanne Malley Fitzgerald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861721235 PECOS PAC ID: 0840633988 Enrollment ID: I20240206003313 |
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