Healthcare Provider Details

I. General information

NPI: 1538655865
Provider Name (Legal Business Name): RACHEL WINKLE MMS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 N MICHIGAN AVE STE 700
CHICAGO IL
60611-6662
US

IV. Provider business mailing address

737 N MICHIGAN AVE STE 700
CHICAGO IL
60611-6662
US

V. Phone/Fax

Practice location:
  • Phone: 312-337-6960
  • Fax: 312-337-3601
Mailing address:
  • Phone: 312-337-6960
  • Fax: 312-337-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085006616
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number085006616
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: