Healthcare Provider Details

I. General information

NPI: 1053402206
Provider Name (Legal Business Name): REINA M TARABEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S MICHIGAN AVE MERCY HOSPITAL AND MEDICAL CENTER
CHICAGO IL
60616-2477
US

IV. Provider business mailing address

PO BOX 88487
CHICAGO IL
60680-1487
US

V. Phone/Fax

Practice location:
  • Phone: 312-567-5433
  • Fax: 312-328-7711
Mailing address:
  • Phone: 312-791-2000
  • Fax: 312-791-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: