Marleta Reynolds
Pediatric Surgery
225 E Chicago Ave
Chicago
, Illinois 60611
Marleta Reynolds
Pediatric Surgery
225 E Chicago Ave
Chicago
, Illinois 60611
(312) 227-9637
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Marleta Reynolds
- 225 E Chicago Ave # 118
- Chicago, IL
- Zip : 60611-2991
- Fax : (312) 227-9637
- Phone : (312) 227-4210
Second Address
- Marleta Reynolds
- 225 E Chicago Ave
- Chicago, IL
- Zip : 60611
- Phone : (800) 543-7362
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 036062051 | IL |
National Provider Identifier
| NPI | 1336135904 |
|---|---|
| Provider Name | Marleta Reynolds |
| First Address | Chicago, IL 60611-2991 |
| Second Address | Chicago, IL 60611 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2005 |
| Last Update Date | 10/05/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036062051 | (05) | IL |
| E24553 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.