Healthcare Provider Details

I. General information

NPI: 1568257244
Provider Name (Legal Business Name): AUSTIN EDWARD RAUSCH CPHT-ADV, BCHCPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 N ARLINGTON HEIGHTS RD STE 101
ITASCA IL
60143-1449
US

IV. Provider business mailing address

620 W ADDISON ST APT 105
CHICAGO IL
60613-4446
US

V. Phone/Fax

Practice location:
  • Phone: 630-495-2899
  • Fax: 630-563-9009
Mailing address:
  • Phone: 312-723-6237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number049.283309
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: