MEDICARE: RACHEL MCGOVERN PANTHER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1851228951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MCGOVERN PANTHER

Provider Business Mailing Address
First Line	:	868 N WELLS ST APT 516
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-3674
Country	:	US
Telephone Number	:	913-223-9924
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 W BELMONT AVE STE 309
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3241
Country	:	US
Telephone Number	:	312-485-1533
Fax Number	:

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

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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