Healthcare Provider Details

I. General information

NPI: 1467965012
Provider Name (Legal Business Name): RACHEL MARIE HUDSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL MUCKIAN

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 FARMINGTON LAKES DR
OSWEGO IL
60543-5109
US

IV. Provider business mailing address

9500 BORMET DR STE 304
MOKENA IL
60448-8399
US

V. Phone/Fax

Practice location:
  • Phone: 331-226-1793
  • Fax:
Mailing address:
  • Phone: 815-469-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.012241
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056012241
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: