Provider Demographics
NPI:1053968750
Name:VAN LOAN, REBECCA (LCPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VAN LOAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CABOT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3628
Mailing Address - Country:US
Mailing Address - Phone:847-485-9265
Mailing Address - Fax:
Practice Address - Street 1:2525 CABOT DR STE 201
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3628
Practice Address - Country:US
Practice Address - Phone:847-485-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180014899101YP2500X
IL178015595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional