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NPI Code Detail

MEDICARE: DR. SUZAN L RAYNER M.D.

MEDICARE: DR. SUZAN L RAYNER M.D.
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
1208100000XPhysical Medicine & Rehabilitation PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609868850
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZAN L RAYNER M.D.
Provider Business Mailing Address
First Line : PO BOX 7227
Second Line :
City : WESTCHESTER
State : IL
Zip : 60154-7227
Country : US
Telephone Number : 708-786-2900
Fax Number :
Provider Business Practice Location Address
First Line : 1401 S CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1858
Country : US
Telephone Number : 773-522-2010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 07/08/2007

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