MEDICARE: RACHEL SLEDD IANNANTUONI MFA

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1568600070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SLEDD IANNANTUONI MFA

Provider Business Mailing Address
First Line	:	30 E LAKE ST
Second Line	:	HAROLD WASHINGTON COLLEGE, ENGLISH/SPEECH DEPT
City	:	CHICAGO
State	:	IL
Zip	:	60601-2408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 E LAKE ST
Second Line	:	HAROLD WASHINGTON COLLEGE, ENGLISH/SPEECH DEPT
City	:	CHICAGO
State	:	IL
Zip	:	60601-2408
Country	:	US
Telephone Number	:	312-553-5600
Fax Number	:

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

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	02/07/2011

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