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General NPI Number Information
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NPI Number | 1104124056
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Entity Type | Individual
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Provider Name | EDWARD RHODES LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 65 E WACKER PL SUITE 2240
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City | CHICAGO
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State | IL
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Zip | 60601
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Country | US
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Telephone | 312-332-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 N FRANCISCO AVE APT. 1N
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City | CHICAGO
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State | IL
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Zip | 60622-5113
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Country | US
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Telephone | 773-384-2671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.007724
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License Number State | IL
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