Healthcare Provider Details

I. General information

NPI: 1891610804
Provider Name (Legal Business Name): REBECCA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

122 S MICHIGAN AVE
CHICAGO IL
60603-6191
US

IV. Provider business mailing address

39917 N MAUSER DR
WADSWORTH IL
60083-9304
US

V. Phone/Fax

Practice location:
  • Phone: 847-404-3010
  • Fax:
Mailing address:
  • Phone: 847-404-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.022381
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: