Provider Demographics
NPI:1790997831
Name:COOK, RACHEL LAURA (LAC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LAURA
Last Name:COOK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1437 W ARGYLE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3502
Mailing Address - Country:US
Mailing Address - Phone:773-962-1766
Mailing Address - Fax:
Practice Address - Street 1:2764 N LINCOLN AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1321
Practice Address - Country:US
Practice Address - Phone:773-935-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist