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NPI Code Detail

MEDICARE: DR. RACHEL ELIZABETH SMITH PSYD, MA, NCC

MEDICARE: DR. RACHEL ELIZABETH SMITH PSYD, MA, NCC
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
1103TC0700XClinical Psychologist071.009661IL

General Provider Information

NPI Number : 1801300439
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL ELIZABETH SMITH PSYD, MA, NCC
Provider Business Mailing Address
First Line : 2950 W CHICAGO AVE STE 202
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4377
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2950 W CHICAGO AVE STE 202
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4377
Country : US
Telephone Number : 773-627-2112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2017
Last Update Date : 03/31/2025

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