Healthcare Provider Details

I. General information

NPI: 1609730001
Provider Name (Legal Business Name): RACHEL GOWLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N MAIN ST STE 103
GLEN ELLYN IL
60137-3572
US

IV. Provider business mailing address

3110 W BELMONT AVE UNIT 3E
CHICAGO IL
60618-5787
US

V. Phone/Fax

Practice location:
  • Phone: 630-480-9188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.021690
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: