Provider Demographics
NPI:1982238135
Name:RANALLO, RENA (PA-C)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:RANALLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2525 KANEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2578
Mailing Address - Country:US
Mailing Address - Phone:630-938-4011
Mailing Address - Fax:630-584-1733
Practice Address - Street 1:2525 KANEVILLE RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2578
Practice Address - Country:US
Practice Address - Phone:630-938-4011
Practice Address - Fax:630-584-1733
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant