MEDICARE: RACHEL N PAETOW

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	235Z00000X	Speech-Language Pathologist	146.012813	IL

General Provider Information

NPI Number	:	1710498191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL N PAETOW

Provider Business Mailing Address
First Line	:	1256 JANE AVE
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-5637
Country	:	US
Telephone Number	:	217-649-6154
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 LEVERENZ RD
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4723
Country	:	US
Telephone Number	:	630-428-7200
Fax Number	:

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

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	10/12/2017

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Directions to “ RACHEL N PAETOW ” Practice Location

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