MEDICARE: MS. REBECCA A EHLER LCPC

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	101YM0800X	Mental Health Counselor	178.007559	IL

General Provider Information

NPI Number	:	1508147521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA A EHLER LCPC

Provider Business Mailing Address
First Line	:	6030 N SHERIDAN RD APT 2112
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-2925
Country	:	US
Telephone Number	:	847-494-0143
Fax Number	:

Provider Business Practice Location Address
First Line	:	4610 N CLARK ST # 1054
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4620
Country	:	US
Telephone Number	:	312-625-2435
Fax Number	:

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

Provider Enumeration Date	:	09/03/2011
Last Update Date	:	09/25/2021

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