Rachel Logan Bennett

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.024056 Issued in IL

Practice address

6639 N Kedzie Ave
Chicago, IL 60645-4161

Phone

(773) 765-3122

NPI assigned

Oct 23, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Rachel Falk Logan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1679116552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 N BOSWORTH AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135741",
            "telephone_number": "781-572-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6639 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454161",
            "telephone_number": "773-765-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RACHEL",
        "middle_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801105825",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "LOGAN",
            "middle_name": "FALK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nelson E Bennett Jr., MD
• Nikole R Bennett, LCSW
• Noel Miriam Bennett, M.D.
• Peter Sylvester Bennett, PH.D.
• Rachel Bennett, RN
• Raymond M Bennett Jr., B.S. PHARM
• Samuel Richard Bennett
• Sarah Bennett
• Shawnte F Bennett, ALMFT
• Stephen G Bennett

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.