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NPI Code Detail

MEDICARE: MS. RACHEL BENNETT RN

MEDICARE: MS. RACHEL BENNETT RN
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
1163WC1500XCommunity Health Registered Nurse041406530IL

General Provider Information

NPI Number : 1316364433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHEL BENNETT RN
Provider Business Mailing Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-969-5933
Fax Number :
Provider Business Practice Location Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-969-5933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2014
Last Update Date : 03/26/2014

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