Individual
CHANTAL R REYNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 585-5506
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME117508
FL
2086X0206X
Surgical Oncology Physician
Primary
036163442
IL
2086X0206X
Surgical Oncology Physician
35134346
OH
2086X0206X
Surgical Oncology Physician
Q0350
TX
390200000X
Student in an Organized Health Care Education/Training Program
LL1881
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340621701
—
TX
Enumeration date
06/24/2008
Last updated
03/21/2023
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