Healthcare Provider Details

I. General information

NPI: 1487155388
Provider Name (Legal Business Name): REBECCA LYNNE TOLLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA LYNNE PACE

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W PARK AVE STE 150
ELMHURST IL
60126-3348
US

IV. Provider business mailing address

180 W PARK AVE STE 150
ELMHURST IL
60126-3348
US

V. Phone/Fax

Practice location:
  • Phone: 630-428-7890
  • Fax:
Mailing address:
  • Phone: 630-428-7890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149016959
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: