Healthcare Provider Details
I. General information
NPI: 1639526015
Provider Name (Legal Business Name): RACHELLE PUNO FLYNN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/16/2016
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9786 ABERDEEN LN
HUNTLEY IL
60142
US
IV. Provider business mailing address
PO BOX 1055
HUNTLEY IL
60142-1055
US
V. Phone/Fax
- Phone: 303-389-0146
- Fax:
- Phone: 630-338-9014
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 12547 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | NUR-APRN-LIC236736 |
| License Number State | MT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 277000381 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 277000381 |
| License Number State | IL |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 95034652 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | APRN-5323-0 |
| License Number State | HI |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 10045433 |
| License Number State | OR |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 239031 |
| License Number State | AK |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | AP.70010308-NP |
| License Number State | WA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 84068 |
| License Number State | NM |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 324797 |
| License Number State | AZ |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2025027002 |
| License Number State | MO |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 14221792-4405 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: