Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 178008556 | IL |
N | 225700000X | Massage Therapist | 227000553 | IL |
NPI | 1013411560 |
---|---|
Provider Name | Rachel Keefer |
First Address | Chicago, IL 60625-5573 |
Second Address | Chicago, IL 60625-5573 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 20/03/2018 |