MEDICARE: THERESA ELIZABETH RANTA APN-CNP

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	363LW0102X	Women's Health Nurse Practitioner	AP30007157	WA
2	363LW0102X	Women's Health Nurse Practitioner	277000901	IL

General Provider Information

NPI Number	:	1609945450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA ELIZABETH RANTA APN-CNP

Provider Business Mailing Address
First Line	:	2180 PFINGSTEN RD STE 3000
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1340
Country	:	US
Telephone Number	:	847-503-3000
Fax Number	:	847-503-3500

Provider Business Practice Location Address
First Line	:	2180 PFINGSTEN RD STE 3000
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1340
Country	:	US
Telephone Number	:	847-503-3000
Fax Number	:	847-503-3500

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/08/2024

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