Active NPI
Rachel Fancher, PSY.D.
- Clinical Psychologist
- Northbrook, IL
National Provider Identifier
1477889202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-008207
- Practice address
- 255 Revere Dr
Northbrook, IL 60062-1564 - Phone
- (847) 412-4350
- NPI assigned
- Oct 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-008207 | IL | Primary |
Addresses
Primary practice location
255 Revere Dr
Northbrook, IL 60062-1564
Mailing address
255 Revere Dr
Northbrook, IL 60062-1564
Phone (847) 412-4350
Other names 1
- Rachel Riley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-008207 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1477889202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 REVERE DR",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621564",
"telephone_number": "847-412-4350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 REVERE DR",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621564",
"telephone_number": "847-412-4350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANCHER",
"first_name": "RACHEL",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-29",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-008207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "RILEY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.