Provider Demographics
NPI:1285779983
Name:RAINA, GRACE ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ELIZABETH
Last Name:RAINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ELIZABETH
Other - Last Name:SMYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:708 E INDEPENDANCE DR APT #5
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074
Mailing Address - Country:US
Mailing Address - Phone:847-305-0066
Mailing Address - Fax:
Practice Address - Street 1:222 SOUTH RIVER SIDE PLAZA SUITE 830
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606
Practice Address - Country:US
Practice Address - Phone:312-416-3804
Practice Address - Fax:312-627-2700
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist