Provider Demographics
NPI:1053770909
Name:SOTELO, RACHEL (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SOTELO
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 N HAMPDEN CT
Mailing Address - Street 2:APT 1W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6289
Mailing Address - Country:US
Mailing Address - Phone:224-522-1067
Mailing Address - Fax:
Practice Address - Street 1:2749 N HAMPDEN CT
Practice Address - Street 2:APT 1W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6289
Practice Address - Country:US
Practice Address - Phone:224-522-1067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-21
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist