Healthcare Provider Details

I. General information

NPI: 1952450801
Provider Name (Legal Business Name): MICHAEL CRAIG RABIN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 FARNSWORTH LN #302
NORTHBROOK IL
60062-3767
US

IV. Provider business mailing address

1950 FARNSWORTH LN #302
NORTHBROOK IL
60062-3767
US

V. Phone/Fax

Practice location:
  • Phone: 312-208-8866
  • Fax: 847-564-3536
Mailing address:
  • Phone: 312-208-8866
  • Fax: 847-564-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: