Provider Demographics
NPI:1780246272
Name:CHWALIK, RACHEL ANNE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:CHWALIK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N STATE ST APT 2904
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5447
Mailing Address - Country:US
Mailing Address - Phone:614-505-9446
Mailing Address - Fax:
Practice Address - Street 1:300 N STATE ST APT 2904
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-5447
Practice Address - Country:US
Practice Address - Phone:614-505-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016517101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health