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General NPI Number Information
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NPI Number | 1003132879
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Entity Type | Individual
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Provider Name | RACHEL CATHERINE TERCEK PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 1653 W. CONGRESS PARKWAY
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 847-933-9339
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 N. CLEVELAND AVE UNIT 3
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City | CHICAGO
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State | IL
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Zip | 60610
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Country | US
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Telephone | 847-302-5029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007865
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License Number State | IL
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