Provider Demographics
NPI:1306072855
Name:WOOD, RACHEL ERIN (AUD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ERIN
Last Name:WOOD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 RACHEL COOPER CAMPUS BOX 4720
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61790-0001
Mailing Address - Country:US
Mailing Address - Phone:504-568-4338
Mailing Address - Fax:
Practice Address - Street 1:211 RACHEL COOPER CAMPUS 4720
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61790-2262
Practice Address - Country:US
Practice Address - Phone:309-438-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7568231H00000X, 237600000X
IL147.001768237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist