Provider Demographics
NPI:1659038735
Name:LAKDAWALA, RACHEL (SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LAKDAWALA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5314
Mailing Address - Country:US
Mailing Address - Phone:630-590-5571
Mailing Address - Fax:630-326-7175
Practice Address - Street 1:1300 REMINGTON RD STE K
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4800
Practice Address - Country:US
Practice Address - Phone:847-496-5513
Practice Address - Fax:847-496-5752
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist