Doctor Name: | MARY REINER |
NPI Number: | 1013266873 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | 085000337 |
Business Practice Address: | 572 S Bartlett Rd Streamwood, IL - 601071362 |
Business Phone Number: | 8476911440 |
Business Fax Number: | 8102222262 |
Mailing Address: | 1 Fernwood Dr, BARRINGTON |
State: | IL |
Postal Code: | 600109682 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/06/2012 |
NPI Last Update Date: | 09/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 085000337 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |