MEDICARE: KATHERINE RACK WELLNESS PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1891639787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHERINE RACK WELLNESS PLLC

Provider Business Mailing Address
First Line	:	2501 CHATHAM RD STE 6508
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62704-4188
Country	:	US
Telephone Number	:	312-426-8731
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 N WINTHROP AVE APT 3E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-6436
Country	:	US
Telephone Number	:	312-426-8731
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	KATHERINE A RACK
Credential	:	LCSW
Telephone Number	:	312-426-8731

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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