Individual
CATHERINE RAE RENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 WEST ST, SUITE 211, PERU, IL 61354-2763
(815) 223-2143
Mailing address
914 30TH ST, PERU, IL 61354-1454
(815) 224-4138
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068623
HEALTH ALLIANCE
IL
Enumeration date
10/18/2006
Last updated
07/09/2007
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