Provider Demographics
NPI:1235360199
Name:DALTON, RACHEL MARIE HATFIELD (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARIE HATFIELD
Last Name:DALTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1505 EASTLAND DR STE 2200
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-7910
Mailing Address - Country:US
Mailing Address - Phone:309-454-3456
Mailing Address - Fax:309-454-6977
Practice Address - Street 1:1505 EASTLAND DR STE 2200
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-7910
Practice Address - Country:US
Practice Address - Phone:309-454-3456
Practice Address - Fax:309-454-6977
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125052728207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology