Provider Demographics
NPI:1154872844
Name:WULFSOHN, RACHEL GABRIELLE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GABRIELLE
Last Name:WULFSOHN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:GABRIELLE
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:3105 N WILKE RD STE H
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:975 E NERGE RD STE W20
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-4812
Practice Address - Country:US
Practice Address - Phone:224-520-8562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056011696225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist