Provider Demographics
NPI:1669711776
Name:RENGANATHAN, MEENA (PT)
Entity type:Individual
Prefix:MS
First Name:MEENA
Middle Name:
Last Name:RENGANATHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15900 SOUTH CICERO AVE
Mailing Address - Street 2:OAK FOREST HOSPITAL OF COOK COUNTY
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4006
Mailing Address - Country:US
Mailing Address - Phone:708-633-2100
Mailing Address - Fax:708-633-2129
Practice Address - Street 1:15900 SOUTH CICERO AVE
Practice Address - Street 2:OAK FOREST HOSPITAL OF COOK COUNTY
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4006
Practice Address - Country:US
Practice Address - Phone:708-633-2100
Practice Address - Fax:708-633-2129
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0075112251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology