Provider Demographics
NPI:1275903866
Name:HUBBARD-JOHNSON, REBECCA RENEE (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RENEE
Last Name:HUBBARD-JOHNSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:RENEE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-888-3361
Mailing Address - Fax:
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 501
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-888-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009146103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling