Healthcare Provider Details

I. General information

NPI: 1851228951
Provider Name (Legal Business Name): RACHEL MCGOVERN PANTHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W BELMONT AVE STE 309
CHICAGO IL
60657-3241
US

IV. Provider business mailing address

868 N WELLS ST APT 516
CHICAGO IL
60610-3674
US

V. Phone/Fax

Practice location:
  • Phone: 312-485-1533
  • Fax:
Mailing address:
  • Phone: 913-223-9924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: