MEDICARE: REENA GEORGE

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	209010677	IL

General Provider Information

NPI Number	:	1649693656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REENA GEORGE

Provider Business Mailing Address
First Line	:	1410 W RUSSELL CT
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-3480
Country	:	US
Telephone Number	:	847-693-1883
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 W RUSSELL CT
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-3480
Country	:	US
Telephone Number	:	847-693-1883
Fax Number	:

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

Provider Enumeration Date	:	01/27/2014
Last Update Date	:	04/23/2021

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Directions to “ REENA GEORGE ” Practice Location

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