Healthcare Provider Details

I. General information

NPI: 1386316164
Provider Name (Legal Business Name): REBECCA SEBREE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST STE 2060
CHICAGO IL
60611-2994
US

IV. Provider business mailing address

259 E ERIE ST STE 2060
CHICAGO IL
60611-2994
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-6022
  • Fax: 312-695-5672
Mailing address:
  • Phone: 312-695-6022
  • Fax: 312-695-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149028295
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: