Provider Demographics
NPI:1457577520
Name:GERE, RACHAEL A (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:A
Last Name:GERE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 SAVANNA DR
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-5009
Mailing Address - Country:US
Mailing Address - Phone:847-340-0886
Mailing Address - Fax:847-487-4022
Practice Address - Street 1:2548 SAVANNA DR
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-5009
Practice Address - Country:US
Practice Address - Phone:847-340-0886
Practice Address - Fax:847-487-4022
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist