Provider Demographics
NPI:1497268528
Name:LEONE, RACHEL (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LEONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GOVERNORS DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IL
Mailing Address - Zip Code:62634-6092
Mailing Address - Country:US
Mailing Address - Phone:630-776-3315
Mailing Address - Fax:
Practice Address - Street 1:208 N WEST AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IL
Practice Address - Zip Code:62664-1066
Practice Address - Country:US
Practice Address - Phone:630-776-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-11
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist