Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125069296 | IL |
N | 111NI0900X | Internist | 125069296 | IL |
Y | 207RI0200X | Infectious Disease | 036152465 | IL |
N | 208000000X | Pediatrician | 125069296 | IL |
NPI | 1033569694 |
---|---|
Provider Name | Rachel Medernach |
First Address | Chicago, IL 60611-2908 |
Second Address | Chicago, IL 60611-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 23/06/2020 |