Provider Demographics
NPI:1639678071
Name:RAUSCH, RAQUEL MARIE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:MARIE
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2407
Mailing Address - Country:US
Mailing Address - Phone:773-687-9442
Mailing Address - Fax:
Practice Address - Street 1:1921 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2407
Practice Address - Country:US
Practice Address - Phone:773-687-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-11
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-17-43732106S00000X
IL1-21-48097103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician