CATHERINE RAE RENK (NPI# 1487735353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487735353 |
| Entity Type | Individual |
| Full Name | CATHERINE RAE RENK |
| Practice Address |
920 West St Suite 211 Peru IL 61354-2763 |
| Mailing Address |
914 30th St Peru IL 61354-1454 |
| Practice Telephone | 8152232143 |
| Mailing Telephone | 8152244138 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTH ALLIANCE | 068623 | 01 |
| Street Address |
920 WEST ST SUITE 211 |
| City | PERU |
| State | IL |
| Zip Code | 61354-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114939 | Mark Allen Fernandez | Internal Medicine | 920 West St, Ste 311, Peru, IL 61354-2770 | 2005-06-16 |
| 1386199511 | Jennifer Leeann Olesen | Nurse Practitioner | 920 West St, Suite #311, Peru, IL 61354-2763 | 2016-08-17 |
| 1851764369 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 311, Peru, IL 61354-2763 | 2015-11-05 |
| 1598138000 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Bldg B, Peru, IL 61354-2763 | 2015-11-05 |
| 1831521947 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Sutie 312, Peru, IL 61354-2763 | 2013-07-31 |
| 1467884650 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 312, Peru, IL 61354-2763 | 2013-07-30 |
| 1073871893 | Ram L & Neelam Goel Ptr | Internal Medicine | 920 West St, Suite 116, Peru, IL 61354-2763 | 2012-04-30 |
| 1912295270 | Illinois Valley Community Hospital | Family Medicine | 920 West St, Suite 311, Peru, IL 61354-2763 | 2011-07-20 |
| 1710281787 | Illinois Valley Community Hospital | Clinic/Center | 920 West St, Suite 216, Peru, IL 61354-2763 | 2011-01-05 |
| 1699005678 | Angela Marie Vezzetti | Physician Assistant | 920 West St, Suite 312, Peru, IL 61354-2763 | 2010-01-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1205469483 | Illinois Valley Community Hospital | Registered Nurse | 1403 Sixth Street, Peru, IL 61354 | 2020-02-17 |
| 1689228322 | Zhong Xue | Dentist | 5301 Il-251, Ste A, Peru, IL 61354 | 2019-07-31 |
| 1003281668 | Christopher Shane Smith | Physical Therapist | 1400 Midtown Road, Peru, IL 61354 | 2015-12-08 |
| 1770823197 | Muscle Pain Clinic Inc | Chiropractor | 4231 Progress Blvd Ste 4, Peru, IL 61354 | 2013-02-21 |
| 1306194451 | Vijaya Lakshmi Bathina | Dentist | 5301 Route 251, Peru, IL 61354 | 2012-08-21 |
| 1225305634 | Walgreens | Point of Service | 1033 Shooting Park Road, Peru, IL 61354 | 2011-11-30 |
| 1811293574 | Charles Riva | Physical Therapist | 4461 N. Progress Blvd., Peru, IL 61354 | 2011-01-28 |
| 1932403896 | Emerging Vision, Inc | Eyewear Supplier (Equipment, not the service) | 3940 Route 251, Peru Mall Suite F-1, Peru, IL 61354 | 2011-01-06 |
| 1457668170 | Illinois Valley Community Hospital | Nurse Practitioner | 5307 Route 251, Peru, IL 61354 | 2010-09-01 |
| Find all providers in zip 61354 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.