Provider Demographics
NPI:1558139840
Name:DR RACHEL LEIBOVITZ DC PLLC
Entity Type:Organization
Organization Name:DR RACHEL LEIBOVITZ DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIBOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-698-8736
Mailing Address - Street 1:1971 N FREMONT ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3591
Mailing Address - Country:US
Mailing Address - Phone:630-484-0844
Mailing Address - Fax:
Practice Address - Street 1:1971 N FREMONT ST UNIT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3591
Practice Address - Country:US
Practice Address - Phone:630-484-0844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty