Reynolds, Marleta

Reynolds, Marleta is an individual health care provider with primary practice located at 225 E Chicago Ave , Chicago IL 60611. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as her primary health care specialty. Reynolds, Marleta can be contacted via phone (800) 543-7362.

Contact Information

Primary practice address
225 E Chicago Ave Chicago IL 60611
Phone: (800) 543-7362
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 036062051 Illinois

Profile Details

NPI number 1336135904
LBN Legal business name Reynolds, Marleta
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated May 10th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336135904 NPPES
Illinois MEDICAID 036062051

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