MEDICARE: MRS. RAINA A GEORGE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209015672	IL
2	363L00000X	Nurse Practitioner	209015672	IL

General Provider Information

NPI Number	:	1497266126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RAINA A GEORGE FNP

Provider Business Mailing Address
First Line	:	2160 S 1ST AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-3328
Country	:	US
Telephone Number	:	708-216-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 S WILKE RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1533
Country	:	US
Telephone Number	:	847-259-8379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2017
Last Update Date	:	02/03/2026

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