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General NPI Number Information
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NPI Number | 1053385567
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Entity Type | Organization
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Legal Business Name | DR. RAINA & ASSOCITATES (CHICAGO RIDGE), LTD
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 6501 95TH ST
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-2632
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Country | US
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Telephone | 708-422-3377
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Fax | 216-584-1023
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Provider Business Mailing Address
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Address Line | 7160 DALLAS PKWY STE 400
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City | PLANO
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State | TX
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Zip | 75024-7111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER CREDENTIALING
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Name | RACHEL NITTINGER
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Credential |
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Telephone | 972-755-0816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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