Healthcare Provider Details

I. General information

NPI: 1407369945
Provider Name (Legal Business Name): RACHEL M OLVERA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W SCHAUMBURG RD
SCHAUMBURG IL
60194
US

IV. Provider business mailing address

600 OAKMONT LN STE 600C
WESTMONT IL
60559-5548
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-7100
  • Fax: 847-490-9356
Mailing address:
  • Phone: 630-575-6250
  • Fax: 630-575-7450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070023660
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: