Provider Demographics
NPI:1639526015
Name:FLYNN, RACHELLE PUNO (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:PUNO
Last Name:FLYNN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:PUNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 LEE ST STE 450
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4545
Mailing Address - Country:US
Mailing Address - Phone:847-768-9330
Mailing Address - Fax:
Practice Address - Street 1:701 LEE ST STE 450
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4545
Practice Address - Country:US
Practice Address - Phone:847-768-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000381363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner