Organization
RAE RICH, LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAE RICH LCSW (PRESIDENT)
(847) 687-3085
Entity
Organization
Contact information
Practice address
1509 W BERWYN AVE, SUITE 209, CHICAGO, IL 60640-8056
(847) 687-3085
Mailing address
1509 W BERWYN AVE, SUITE 209, CHICAGO, IL 60640-8056
(847) 687-3085
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149002472
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1623160
BLUE CROSS BLUE SHIELD
IL
01
—
1982641627
PERSONAL NPI
IL
Enumeration date
02/27/2007
Last updated
04/08/2014
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