Provider Demographics
NPI:1326588468
Name:SHIMEK, RACHEL N (MS, OTR)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:SHIMEK
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:N
Other - Last Name:MASSART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7226
Mailing Address - Fax:920-445-7238
Practice Address - Street 1:555 REDBIRD CIR STE 300
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-7980
Practice Address - Country:US
Practice Address - Phone:920-338-6870
Practice Address - Fax:920-338-6829
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6042-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist