Provider Demographics
NPI:1497474928
Name:RAPACCHIETTA, KATELYN M (RN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:M
Last Name:RAPACCHIETTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 W SCHILLER ST APT 2408
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2044
Mailing Address - Country:US
Mailing Address - Phone:313-530-9095
Mailing Address - Fax:
Practice Address - Street 1:88 W SCHILLER ST APT 2408
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2044
Practice Address - Country:US
Practice Address - Phone:313-530-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.452605163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse