Provider Demographics
NPI:1932568045
Name:REH, CHRISTINE (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:REH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:REH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:2139 N SEMINARY AVE
Mailing Address - Street 2:APT. 4
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4168
Mailing Address - Country:US
Mailing Address - Phone:314-322-1172
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:SUITE 1408
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-281-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IL071.009318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist