MEDICARE: RACHEL ETSHOKIN 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	101Y00000X	Counselor	180.013392	IL
2	101Y00000X	Counselor	178.014384	IL

General Provider Information

NPI Number	:	1437700689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ETSHOKIN LCPC

Provider Business Mailing Address
First Line	:	4440 N DAMEN AVE APT 3W
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-1719
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3934 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2432
Country	:	US
Telephone Number	:	773-549-1700
Fax Number	:

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

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	08/02/2021

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Directions to “ RACHEL ETSHOKIN LCPC” Practice Location

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