Healthcare Provider Details

I. General information

NPI: 1073904348
Provider Name (Legal Business Name): REBEKAH FRANCES DEES-MCMAHON D. MIN..
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH FRANCES DEES D. MIN.

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 E COLLEGE ST
KEWANEE IL
61443-3703
US

IV. Provider business mailing address

P.O. BOX 643 17822 575 E. ST.
SHEFFIELD IL
61361
US

V. Phone/Fax

Practice location:
  • Phone: 309-852-4331
  • Fax: 309-854-0122
Mailing address:
  • Phone: 815-454-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number077277
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberP1411094
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1411094
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2015007726
License Number StateMO
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.006707
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: