MEDICARE: RACHEL LYNN EVAK

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	235Z00000X	Speech-Language Pathologist	146.016093	IL

General Provider Information

NPI Number	:	1154098895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LYNN EVAK

Provider Business Mailing Address
First Line	:	2558 ANNA MARIA LN
Second Line	:
City	:	YORKVILLE
State	:	IL
Zip	:	60560-2424
Country	:	US
Telephone Number	:	630-272-9421
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 MEADOW LAKE DR
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4362
Country	:	US
Telephone Number	:	630-428-7100
Fax Number	:

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

Provider Enumeration Date	:	08/29/2021
Last Update Date	:	02/11/2022

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Directions to “ RACHEL LYNN EVAK ” Practice Location

Language	Start Address	Practice Location

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