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General NPI Number Information
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NPI Number | 1558932640
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Entity Type | Individual
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Provider Name | RACHAEL WUEST PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 480 E ROOSEVELT RD STE 105
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3969
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Country | US
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Telephone | 630-492-1965
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Fax |
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Provider Business Mailing Address
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Address Line | 480 E ROOSEVELT RD STE 105
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3969
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Country | US
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Telephone | 630-492-1965
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-008631
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License Number State | IL
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