Provider Demographics
NPI:1982431953
Name:DEMARCHI, REBECCA SUE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:DEMARCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUE
Other - Last Name:MARINARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2608 NOYES ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2171
Mailing Address - Country:US
Mailing Address - Phone:347-831-4751
Mailing Address - Fax:
Practice Address - Street 1:444 N NORTHWEST HWY STE 250
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3276
Practice Address - Country:US
Practice Address - Phone:347-831-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112150104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker