MEDICARE: RACHEL BAKER

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	101YP2500X	Professional Counselor	178.012438	IL
2	101YP2500X	Professional Counselor	180.012815	IL

General Provider Information

NPI Number	:	1881146314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BAKER

Provider Business Mailing Address
First Line	:	2901 N SEELEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-8306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5412 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1223
Country	:	US
Telephone Number	:	773-922-0976
Fax Number	:	847-498-4234

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

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	09/02/2020

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Directions to “ RACHEL BAKER ” Practice Location

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