Healthcare Provider Details

I. General information

NPI: 1609650357
Provider Name (Legal Business Name): RACHEL DEUTSCH DNP, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W FULTON MARKET
CHICAGO IL
60607-1334
US

IV. Provider business mailing address

225 W HURON ST APT 301
CHICAGO IL
60654-3943
US

V. Phone/Fax

Practice location:
  • Phone: 773-270-8762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAG08230060
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: