Provider Demographics
NPI:1275106841
Name:KISTLER, RACHEL FRANCINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:FRANCINE
Last Name:KISTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 BURNS LN
Mailing Address - Street 2:
Mailing Address - City:MINOOKA
Mailing Address - State:IL
Mailing Address - Zip Code:60447-4557
Mailing Address - Country:US
Mailing Address - Phone:815-931-9865
Mailing Address - Fax:
Practice Address - Street 1:15025 S DES PLAINES ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-1868
Practice Address - Country:US
Practice Address - Phone:630-328-0142
Practice Address - Fax:877-428-7891
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IL1490286491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker