Provider Demographics
NPI:1538056387
Name:RAKHMAN, MAYA (NP)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:RAKHMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 PRESTWICK LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5122
Mailing Address - Country:US
Mailing Address - Phone:224-558-3665
Mailing Address - Fax:
Practice Address - Street 1:400 SKOKIE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7927
Practice Address - Country:US
Practice Address - Phone:847-498-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.032554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily