Healthcare Provider Details

I. General information

NPI: 1801856836
Provider Name (Legal Business Name): RACHEL EVELYN STORY MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CENTRAL ST
EVANSTON IL
60201-1777
US

IV. Provider business mailing address

2650 RIDGE AVE
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2431
  • Fax: 847-733-5109
Mailing address:
  • Phone: 847-570-2431
  • Fax: 847-733-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036105712
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: