Provider Demographics
NPI:1649803560
Name:WESTRATE, REBECCA JOY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JOY
Last Name:WESTRATE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 BROWN ST STE A
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1747
Mailing Address - Country:US
Mailing Address - Phone:847-795-3340
Mailing Address - Fax:
Practice Address - Street 1:224 BROWN ST STE A
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-1747
Practice Address - Country:US
Practice Address - Phone:847-795-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020639363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine