Provider Demographics
NPI:1285741280
Name:HAMILTON, REBECCA SUSAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SUSAN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 FURMAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2937
Mailing Address - Country:US
Mailing Address - Phone:630-328-3419
Mailing Address - Fax:
Practice Address - Street 1:1999 W 75TH STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2610
Practice Address - Country:US
Practice Address - Phone:630-784-4979
Practice Address - Fax:630-784-4985
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK11153Medicare ID - Type Unspecified