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NPI Code Detail

MEDICARE: ANNI RASMUSSEN LCPC, CADC

MEDICARE: ANNI RASMUSSEN LCPC, CADC
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
1101YP2500XProfessional Counselor180.010043IL

General Provider Information

NPI Number : 1750806931
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNI RASMUSSEN LCPC, CADC
Provider Business Mailing Address
First Line : 15205 BRASSIE DR
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-4125
Country : US
Telephone Number : 708-712-8788
Fax Number :
Provider Business Practice Location Address
First Line : 1800 RAVINIA PL
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3761
Country : US
Telephone Number : 708-403-7570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 08/08/2017

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