Basic Information
| Provider Information | |||||||||
| NPI: | 1396989257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TREUTING | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | STONE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4225 LINCOLNSHIRE DR STE B | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 628642157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182422317 | ||||||||
| FaxNumber: | 6182429710 | ||||||||
| Practice Location | |||||||||
| Address1: | 153 E MONTE PAINTER DR | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727034002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794442200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2009 | ||||||||
| LastUpdateDate: | 04/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 68576-21 | WI | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | DO.000268 | LA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 65376 | MN | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 1396989257 | 05 | LA | MEDICAID |