MEDICARE: JACQUELINE RHEW, LCPC, LTD

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1528420254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACQUELINE RHEW, LCPC, LTD

Provider Business Mailing Address
First Line	:	3413 N KENNICOTT AVE
Second Line	:	SUITE A
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-7815
Country	:	US
Telephone Number	:	847-668-2842
Fax Number	:	847-670-9611

Provider Business Practice Location Address
First Line	:	3413 N KENNICOTT AVE
Second Line	:	SUITE A
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-7815
Country	:	US
Telephone Number	:	847-668-2842
Fax Number	:	847-670-9611

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACQUELINE RHEW
Credential	:	LCPC
Telephone Number	:	847-668-2842

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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