Healthcare Provider Details

I. General information

NPI: 1861979809
Provider Name (Legal Business Name): RAYNA SCHULTEIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 E RICHTON RD
CRETE IL
60417-1623
US

IV. Provider business mailing address

1192 MEADOW PATH
MANTENO IL
60950-3740
US

V. Phone/Fax

Practice location:
  • Phone: 708-672-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.008234
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: