Individual
REENA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
675 N SAINT CLAIR ST STE 19-250, CHICAGO, IL 60611-5964
(312) 694-2428
(312) 695-5672
Mailing address
675 N SAINT CLAIR ST STE 19-250, CHICAGO, IL 60611-5964
(312) 694-2428
(312) 695-5672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002660
IL
363AS0400X
Surgical Physician Assistant
085002660
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00447360
RAILROAD MEDICARE
IL
Enumeration date
07/12/2006
Last updated
03/31/2022
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