Healthcare Provider Details

I. General information

NPI: 1013411560
Provider Name (Legal Business Name): RACHEL KEEFER LPC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 N SPAULDING AVE APT 2
CHICAGO IL
60625-5573
US

IV. Provider business mailing address

4535 N SPAULDING AVE APT 2
CHICAGO IL
60625-5573
US

V. Phone/Fax

Practice location:
  • Phone: 312-339-6213
  • Fax:
Mailing address:
  • Phone: 312-339-6213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number227000553
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number227000553
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227000553
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178008556
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: