Provider Demographics
NPI:1487961355
Name:RAKE, VICTORIA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:RAKE
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:6119 NORTHWEST HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7911
Mailing Address - Country:US
Mailing Address - Phone:815-477-8844
Mailing Address - Fax:815-308-3387
Practice Address - Street 1:6119 NORTHWEST HWY
Practice Address - Street 2:SUITE B
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7911
Practice Address - Country:US
Practice Address - Phone:815-477-8844
Practice Address - Fax:815-308-3387
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2012-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL038011765111N00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation