MEDICARE: RACHEL AMDUR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124145172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL AMDUR M.D.

Provider Business Mailing Address
First Line	:	180 HARVESTER DR STE 110
Second Line	:	SUITE 110
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-6686
Country	:	US
Telephone Number	:	773-834-1061
Fax Number	:	773-834-0946

Provider Business Practice Location Address
First Line	:	1111 E 87TH ST
Second Line	:	SUITE 900
City	:	CHICAGO
State	:	IL
Zip	:	60619-7038
Country	:	US
Telephone Number	:	773-702-2900
Fax Number	:	773-702-2277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/09/2007

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