Healthcare Provider Details

I. General information

NPI: 1043156698
Provider Name (Legal Business Name): DR. RACHEL ISABEL TEITELBAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 E OGDEN AVE
NAPERVILLE IL
60563-8560
US

IV. Provider business mailing address

123 S GREEN ST APT 408B
CHICAGO IL
60607-3494
US

V. Phone/Fax

Practice location:
  • Phone: 630-778-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number019.036970
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: