Healthcare Provider Details

I. General information

NPI: 1124559042
Provider Name (Legal Business Name): RACHEL LYNN LEFFERDINK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL LYNN THOMPSON MD

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CENTRAL AVE STE 100
HIGHLAND PARK IL
60035-2622
US

IV. Provider business mailing address

445 CENTRAL AVE STE 100
HIGHLAND PARK IL
60035-2622
US

V. Phone/Fax

Practice location:
  • Phone: 847-996-3376
  • Fax: 847-986-0310
Mailing address:
  • Phone: 847-996-3376
  • Fax: 847-986-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036174349
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: