Healthcare Provider Details

I. General information

NPI: 1598513541
Provider Name (Legal Business Name): RACHEL MAURER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 06/15/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PAULINA ST STE 403
CHICAGO IL
60612-3806
US

IV. Provider business mailing address

1645 W JACKSON BLVD STE 200
CHICAGO IL
60612-3227
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125.085925
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: