Provider Demographics
NPI:1497320212
Name:GREER, RACHEL SPNCER
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SPNCER
Last Name:GREER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:MORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 DIANNA DR
Mailing Address - Street 2:
Mailing Address - City:GILLESPIE
Mailing Address - State:IL
Mailing Address - Zip Code:62033-1954
Mailing Address - Country:US
Mailing Address - Phone:815-703-6109
Mailing Address - Fax:
Practice Address - Street 1:411 DIANNA DR
Practice Address - Street 2:
Practice Address - City:GILLESPIE
Practice Address - State:IL
Practice Address - Zip Code:62033-1954
Practice Address - Country:US
Practice Address - Phone:815-703-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041269013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty