Provider Demographics
NPI:1619759081
Name:GORESS, RACHEL DENISE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENISE
Last Name:GORESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4252
Mailing Address - Country:US
Mailing Address - Phone:847-588-1895
Mailing Address - Fax:847-588-1896
Practice Address - Street 1:7317 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4252
Practice Address - Country:US
Practice Address - Phone:847-588-1895
Practice Address - Fax:847-588-1896
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3536237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist