Provider Demographics
NPI:1023392396
Name:DALAL, RACHEL CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:CHRISTINE
Last Name:DALAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1300 FRANKLIN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3676
Mailing Address - Country:US
Mailing Address - Phone:309-268-3761
Mailing Address - Fax:309-268-5620
Practice Address - Street 1:1300 FRANKLIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3676
Practice Address - Country:US
Practice Address - Phone:309-268-3761
Practice Address - Fax:309-268-5620
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125.057800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine