Provider Demographics
NPI:1497117261
Name:MATTHEWS, RACHEL ROCHELLE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ROCHELLE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 N ALFRED AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5206
Mailing Address - Country:US
Mailing Address - Phone:847-695-4847
Mailing Address - Fax:847-695-4902
Practice Address - Street 1:70 N ALFRED AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5206
Practice Address - Country:US
Practice Address - Phone:847-695-4847
Practice Address - Fax:847-695-4902
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.00001276171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist