Provider Demographics
NPI:1831502269
Name:HOLCOMB, RACHEL (DO)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 W 127TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1579
Mailing Address - Country:US
Mailing Address - Phone:708-923-6300
Mailing Address - Fax:708-923-6303
Practice Address - Street 1:7110 W 127TH ST STE 130
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1579
Practice Address - Country:US
Practice Address - Phone:708-923-6300
Practice Address - Fax:708-923-6303
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143317208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036143317Medicaid