Provider Demographics
NPI:1467820035
Name:O'DONNELL, RACHEL ANNETTE (PT, DPT, LAT ATC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANNETTE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:PT, DPT, LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-0220
Mailing Address - Country:US
Mailing Address - Phone:708-590-6663
Mailing Address - Fax:708-469-4100
Practice Address - Street 1:4746 N CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-4239
Practice Address - Country:US
Practice Address - Phone:773-417-8901
Practice Address - Fax:773-717-5607
Is Sole Proprietor?:No
Enumeration Date:2015-09-12
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0053182255A2300X
IL070.026356225100000X, 225100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program