Provider Demographics
NPI:1780428862
Name:NESBURG, RACHEL ANNE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANNE
Last Name:NESBURG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 N AVONDALE AVE STE B-243
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1962
Mailing Address - Country:US
Mailing Address - Phone:231-373-3966
Mailing Address - Fax:
Practice Address - Street 1:2933 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-9897
Practice Address - Country:US
Practice Address - Phone:847-773-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0283172251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports