MEDICARE: RACHEL T LAPE MD

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	208000000X	Pediatrics Physician	036112037	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265438576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL T LAPE MD

Provider Business Mailing Address
First Line	:	PO BOX 372
Second Line	:
City	:	MATTOON
State	:	IL
Zip	:	61938-0372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 RICHMOND AVE E STE 4
Second Line	:
City	:	MATTOON
State	:	IL
Zip	:	61938-4652
Country	:	US
Telephone Number	:	217-238-5345
Fax Number	:	217-238-5348

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/26/2024

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