Healthcare Provider Details

I. General information

NPI: 1043746126
Provider Name (Legal Business Name): RACHEL PAULEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE # 51
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

225 E CHICAGO AVE # 51
CHICAGO IL
60611-2991
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-3540
  • Fax:
Mailing address:
  • Phone: 312-227-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number036160458
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: