Healthcare Provider Details

I. General information

NPI: 1720905474
Provider Name (Legal Business Name): RACHEL BOLLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1979 N MILL ST STE 105
NAPERVILLE IL
60563-1295
US

IV. Provider business mailing address

2443 SHEEHAN DR UNIT 101
NAPERVILLE IL
60564-4892
US

V. Phone/Fax

Practice location:
  • Phone: 630-281-2496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: