Provider Demographics
NPI:1801487418
Name:SPIZZIRRI, RACHEL A
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:SPIZZIRRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 N WILTON AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-0330
Mailing Address - Country:US
Mailing Address - Phone:847-309-3894
Mailing Address - Fax:
Practice Address - Street 1:688 N MILWAUKEE AVE STE 302
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-5912
Practice Address - Country:US
Practice Address - Phone:615-948-8939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178016291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional