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NPI Code Detail

MEDICARE: REBEKAH RAEBURN LCSW

MEDICARE: REBEKAH RAEBURN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149031099IL

General Provider Information

NPI Number : 1053262626
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH RAEBURN LCSW
Provider Business Mailing Address
First Line : 5125 S ELLIS AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60615-6333
Country : US
Telephone Number : 773-412-2297
Fax Number :
Provider Business Practice Location Address
First Line : 2701 W 68TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-1813
Country : US
Telephone Number : 773-565-2550
Fax Number : 773-565-2570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ REBEKAH RAEBURN LCSW” Practice Location

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