Healthcare Provider Details

I. General information

NPI: 1639348584
Provider Name (Legal Business Name): RACHELL BUHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E SCRANTON AVE
LAKE BLUFF IL
60044-2530
US

IV. Provider business mailing address

1103 N OAKLEY CT APT 201
WESTMONT IL
60559-6183
US

V. Phone/Fax

Practice location:
  • Phone: 847-432-4077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011111
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: