Healthcare Provider Details

I. General information

NPI: 1295442655
Provider Name (Legal Business Name): NORA ABDELRAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10528 RIDGE COVE DR APT 13A
CHICAGO RIDGE IL
60415-1476
US

IV. Provider business mailing address

10528 RIDGE COVE DR APT 13A
CHICAGO RIDGE IL
60415-1476
US

V. Phone/Fax

Practice location:
  • Phone: 708-253-5360
  • Fax:
Mailing address:
  • Phone: 708-253-5360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.018130
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.018700
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: