Provider Demographics
NPI:1932706371
Name:SHINGALA, RAKHI
Entity Type:Individual
Prefix:
First Name:RAKHI
Middle Name:
Last Name:SHINGALA
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 1:3444 BREITWIESER LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8293
Mailing Address - Country:US
Mailing Address - Phone:773-391-9476
Mailing Address - Fax:
Practice Address - Street 1:LEGACY CLINICAL CONSULTANT, 13717 S. ROUTE 30
Practice Address - Street 2:159
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:877-443-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional