Provider Demographics
NPI:1306575238
Name:REBECCA IRMEN LLC
Entity type:Organization
Organization Name:REBECCA IRMEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-525-7504
Mailing Address - Street 1:174 E OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2732
Mailing Address - Country:US
Mailing Address - Phone:847-525-7504
Mailing Address - Fax:
Practice Address - Street 1:174 E OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2732
Practice Address - Country:US
Practice Address - Phone:847-525-7504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty