Healthcare Provider Details
I. General information
NPI: 1508024829
Provider Name (Legal Business Name): RACHEL ELIZABETH VINSON MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2008
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
430 PENNSYLVANIA AVE STE 210
GLEN ELLYN IL
60137-4464
US
IV. Provider business mailing address
POB 7132960
CHICAGO IL
60677-0001
US
V. Phone/Fax
- Phone: 630-469-7700
- Fax: 630-545-7851
- Phone: 630-469-9200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD60732107 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 141492 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 2010-00699 |
| License Number State | NC |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036.134488 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: