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General NPI Number Information
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NPI Number | 1972676567
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Entity Type | Organization
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Legal Business Name | RASIDI CONSULTING ASSOCIATES INC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 17076 S PARK AVE 17076 SOUTH PARK AVE SUITE L
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-3349
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Country | US
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Telephone | 708-331-4101
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Fax | 708-331-4755
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Provider Business Mailing Address
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Address Line | 17076 S PARK AVE 17076 SOUTH PARK AVE SUITE L
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-3349
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Country | US
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Telephone | 708-331-4101
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Fax | 708-331-4755
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Authorized Official
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Title or Position | PROPRIETOR OFFICE MANGER
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Name | MS. TRACEY C ADAMS
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Credential | LCPC
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Telephone | 708-331-4101
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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 | 180-005780
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License Number State | IL
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