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General NPI Number Information
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NPI Number | 1184734147
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Entity Type | Individual
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Provider Name | REBECCA L HALL PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 14315 108TH AVE STE 220
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City | ORLAND PARK
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State | IL
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Zip | 60467-5700
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Country | US
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Telephone | 630-779-8525
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Fax | 708-403-6796
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Provider Business Mailing Address
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Address Line | 14315 108TH AVE SUITE 220
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City | ORLAND PARK
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State | IL
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Zip | 60467-5700
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Country | US
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Telephone | 708-669-3311
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178002308
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071007445
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License Number State | IL
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