MEDICARE: STEPHANIE REHOR 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
1	1041C0700X	Clinical Social Worker	149.026651	IL
2	1041C0700X	Clinical Social Worker	34012252A	IN

General Provider Information

NPI Number	:	1447828389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE REHOR LCSW

Provider Business Mailing Address
First Line	:	119 S WESTERN AVE UNIT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-4644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 S WESTERN AVE UNIT 1
Second Line	:	#257
City	:	CHICAGO
State	:	IL
Zip	:	60612-4644
Country	:	US
Telephone Number	:	630-509-8832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	09/25/2025

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