Healthcare Provider Details

I. General information

NPI: 1659196905
Provider Name (Legal Business Name): RAJAA TRAYNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N MICHIGAN AVE STE 1200
CHICAGO IL
60611-4264
US

IV. Provider business mailing address

401 N MICHIGAN AVE STE 1200
CHICAGO IL
60611-4264
US

V. Phone/Fax

Practice location:
  • Phone: 800-494-6163
  • Fax: 800-858-1113
Mailing address:
  • Phone: 800-494-6163
  • Fax: 800-858-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1180286
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: