Provider Demographics
NPI:1386875375
Name:RAFI, RENE (CRNA)
Entity type:Individual
Prefix:MR
First Name:RENE
Middle Name:
Last Name:RAFI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 N PAULINA ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3239
Mailing Address - Country:US
Mailing Address - Phone:773-301-7212
Mailing Address - Fax:
Practice Address - Street 1:1770 1ST ST STE 703
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3261
Practice Address - Country:US
Practice Address - Phone:847-433-1542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-007731367500000X
IL082460367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered