Provider Demographics
NPI:1578099644
Name:RAYNER, CAROLYN W (RN, MPH, CHC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:W
Last Name:RAYNER
Suffix:
Gender:F
Credentials:RN, MPH, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16459 LOCKRIDGE AVE
Mailing Address - Street 2:PARTNER4HEALTH, LLC
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4138
Mailing Address - Country:US
Mailing Address - Phone:708-790-5735
Mailing Address - Fax:
Practice Address - Street 1:16459 LOCKRIDGE AVE
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4138
Practice Address - Country:US
Practice Address - Phone:708-790-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-141830163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse