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NPI Code Detail

MEDICARE: MS. RACHEL SAHTOUT LCSW

MEDICARE:  MS. RACHEL  SAHTOUT  LCSW
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
11041C0700XClinical Social Worker149012933IL

General Provider Information

NPI Number : 1124290614
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHEL SAHTOUT LCSW
Provider Business Mailing Address
First Line : PO BOX 7174
Second Line :
City : ROMEOVILLE
State : IL
Zip : 60446-7074
Country : US
Telephone Number : 815-325-4977
Fax Number :
Provider Business Practice Location Address
First Line : 18161 MORRIS AVE STE 102
Second Line :
City : HOMEWOOD
State : IL
Zip : 60430-2140
Country : US
Telephone Number : 708-349-5433
Fax Number : 708-349-5433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2008
Last Update Date : 04/27/2020

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Directions to “ MS. RACHEL SAHTOUT LCSW” Practice Location

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