MEDICARE: MS. RACHEL LEIGH GREENSPAN LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor		IL

General Provider Information

NPI Number	:	1003030958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL LEIGH GREENSPAN LCPC

Provider Business Mailing Address
First Line	:	1040 W ADAMS ST
Second Line	:	#254
City	:	CHICAGO
State	:	IL
Zip	:	60607-2998
Country	:	US
Telephone Number	:	312-666-4656
Fax Number	:	312-666-4656

Provider Business Practice Location Address
First Line	:	1101 W ADAMS ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-2903
Country	:	US
Telephone Number	:	312-318-8105
Fax Number	:	312-666-4656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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