Provider Demographics
NPI:1881938637
Name:EGGE, RACHAEL ANNE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ANNE
Last Name:EGGE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E WASHINGTON ST
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 E WASHINGTON ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8622
Practice Address - Country:US
Practice Address - Phone:773-848-8438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional