Provider Demographics
NPI:1619683075
Name:VITTARDI, RACHEL
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:VITTARDI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W HURON ST APT 515
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3439
Mailing Address - Country:US
Mailing Address - Phone:440-537-7679
Mailing Address - Fax:
Practice Address - Street 1:954 W WASHINGTON BLVD STE 440
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2224
Practice Address - Country:US
Practice Address - Phone:872-312-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor