Healthcare Provider Details

I. General information

NPI: 1235655598
Provider Name (Legal Business Name): RACHEL ANN PLOSKONKA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 LANDMARK DR STE A
LAFAYETTE IN
47905-6652
US

IV. Provider business mailing address

29943 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 765-807-2780
  • Fax: 317-706-3417
Mailing address:
  • Phone: 317-706-3415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: