Provider Demographics
NPI:1629562178
Name:SINGH, RACHITA R
Entity Type:Individual
Prefix:
First Name:RACHITA
Middle Name:R
Last Name:SINGH
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 1:2722 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1308
Mailing Address - Country:US
Mailing Address - Phone:312-698-9040
Mailing Address - Fax:855-618-2276
Practice Address - Street 1:2722 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1308
Practice Address - Country:US
Practice Address - Phone:312-698-9040
Practice Address - Fax:855-618-2276
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
IL085.008999363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical