Rachel Hartz
Individual provider Active NPI Athletic Trainer · Worth, IL
NPI 1124424130 · NPPES record last updated Nov 18, 2014
Key facts
- NPI
- 1124424130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096003387 (IL)
- Practice address
- 7234 W 110TH St
Worth, IL 60482-1116 - Phone
- (708) 337-0131
- NPI assigned
- Nov 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096003387 | IL | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096003387 | IL | Yes |
Addresses
Primary practice location
7234 W 110TH St
Worth, IL 60482-1116
Mailing address
7234 W 110TH St
Worth, IL 60482-1116
Other providers in Worth, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.