MEDICARE: DR. THEODORE RAPACZ

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	174400000X	Specialist	IL
2	172P00000X	Naprapath	IL
3	133V00000X	Registered Dietitian	IL

General Provider Information

NPI Number	:	1548399801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE RAPACZ

Provider Business Mailing Address
First Line	:	425 S GILBERT AVE
Second Line	:
City	:	LA GRANGE
State	:	IL
Zip	:	60525-2159
Country	:	US
Telephone Number	:	708-354-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	6555 NORTH AVE
Second Line	:	SUITE 104
City	:	OAK PARK
State	:	IL
Zip	:	60302-1059
Country	:	US
Telephone Number	:	708-383-1626
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	09/11/2025

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