| Sandra J Rackley, MD | |
|
18432 Kenrick Ave, Lakeville, MN 55044-9288 | |
| (952) 992-6750 | |
| Not Available |
| Full Name | Sandra J Rackley |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 18432 Kenrick Ave, Lakeville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710967625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 48197 (Minnesota) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 48197 (Minnesota) | Primary |
| Entity Name | Mayo Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922074434 PECOS PAC ID: 6507778255 Enrollment ID: O20031103000285 |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra J Rackley, MD 18432 Kenrick Ave, Lakeville, MN 55044-9288 Ph: (952) 992-6750 | Sandra J Rackley, MD 18432 Kenrick Ave, Lakeville, MN 55044-9288 Ph: (952) 992-6750 |
Dr. Gregory Lloyd Thelen Thelen, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 18837 Iroquois Way, Lakeville, MN 55044 Phone: 612-467-1921 | |
Kenchiro Kue, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 17489 Dodd Blvd, Lakeville, MN 55044 Phone: 952-428-1020 Fax: 952-428-1025 |