MEDICARE: KATELYN M RAPACCHIETTA RN

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	163W00000X	Registered Nurse	041.452605	IL
2	367500000X	Certified Registered Nurse Anesthetist	209030962	IL

General Provider Information

NPI Number	:	1497474928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN M RAPACCHIETTA RN

Provider Business Mailing Address
First Line	:	88 W SCHILLER ST APT 2408
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-2044
Country	:	US
Telephone Number	:	313-530-9095
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 W SCHILLER ST APT 2408
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-2044
Country	:	US
Telephone Number	:	313-530-9095
Fax Number	:

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

Provider Enumeration Date	:	08/26/2022
Last Update Date	:	01/21/2025

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