Healthcare Provider Details

I. General information

NPI: 1154254548
Provider Name (Legal Business Name): RACHEL HOGUE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 W LYNDALE ST APT 1F
CHICAGO IL
60647-2974
US

IV. Provider business mailing address

2829 W LYNDALE ST APT 1F
CHICAGO IL
60647-2974
US

V. Phone/Fax

Practice location:
  • Phone: 231-620-3962
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.027554
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: