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NPI Code Detail

MEDICARE: RACHAEL TREVINO LPC

MEDICARE: RACHAEL TREVINO LPC
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
1101YP2500XProfessional Counselor178014157IL

General Provider Information

NPI Number : 1639631955
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL TREVINO LPC
Provider Business Mailing Address
First Line : 175 E HAWTHORN PKWY STE 235
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1454
Country : US
Telephone Number : 847-737-8768
Fax Number : 847-859-5885
Provider Business Practice Location Address
First Line : 20550 S LAGRANGE RD STE 105
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-1273
Country : US
Telephone Number : 847-868-3435
Fax Number : 847-859-5885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2019
Last Update Date : 04/04/2019

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Directions to “ RACHAEL TREVINO LPC” Practice Location

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