Doctor Name: | MRS. RACHELLE CAMAYA CENTENO |
NPI Number: | 1780827337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 12251 S 80th Ave Palos Heights, IL - 604631256 |
Business Phone Number: | 7089234000 |
Business Fax Number: | |
Mailing Address: | 270 W Loop Road, WHEATON |
State: | IL |
Postal Code: | 60189 |
Phone Number: | 6306538464 |
Fax Number: | 6306538660 |
NPI Enumeration Date: | 04/13/2009 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |