Provider Demographics
NPI:1114414471
Name:ZUTTY, RACHAEL (LCPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:ZUTTY
Suffix:
Gender:F
Credentials:LCPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S MICHIGAN AVE STE 818
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1302
Mailing Address - Country:US
Mailing Address - Phone:872-870-1006
Mailing Address - Fax:
Practice Address - Street 1:410 S MICHIGAN AVE STE 818
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1302
Practice Address - Country:US
Practice Address - Phone:872-870-1006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-21
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15-032221700000X
IL180.010089101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist