Individual
RACHAEL ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
333 N MICHIGAN AVE STE 1801, CHICAGO, IL 60601-3984
(312) 345-0933
Mailing address
PO BOX 2257, CHESTERTON, IN 46304-0357
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009905
IL
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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