Provider Demographics
NPI:1053987883
Name:RABENDA, ERICA
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:
Last Name:RABENDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GODDESS
Other - Middle Name:
Other - Last Name:ERICA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2838 W HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5815
Mailing Address - Country:US
Mailing Address - Phone:708-822-9768
Mailing Address - Fax:
Practice Address - Street 1:980 N MICHIGAN AVE STE 1400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-7500
Practice Address - Country:US
Practice Address - Phone:312-282-5478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula