Provider Demographics
NPI:1104124056
Name:RHODES, EDWARD (LCPC)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:RHODES
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N FRANCISCO AVE
Mailing Address - Street 2:APT. 1N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5113
Mailing Address - Country:US
Mailing Address - Phone:773-384-2671
Mailing Address - Fax:
Practice Address - Street 1:65 E WACKER PL
Practice Address - Street 2:SUITE 2240
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601
Practice Address - Country:US
Practice Address - Phone:312-332-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional