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General NPI Number Information
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NPI Number | 1306267463
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Entity Type | Organization
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Legal Business Name | RACHEL STURGES PSYD LLC
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Dates
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Enumeration Date | 12/16/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 30 N MICHIGAN AVE STE 828
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City | CHICAGO
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State | IL
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Zip | 60602-3789
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Country | US
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Telephone | 773-661-6824
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Fax |
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Provider Business Mailing Address
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Address Line | 456 W DEMING PL APT 4W
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City | CHICAGO
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State | IL
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Zip | 60614-1764
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Country | US
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Telephone | 917-674-9151
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RACHEL CHASE STURGES
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Credential | PSYD
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Telephone | 773-280-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071008735
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License Number State | IL
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