Provider Demographics
NPI:1720332125
Name:MCKEOWN, RENEA CHRISTINE (APN-BC)
Entity type:Individual
Prefix:MS
First Name:RENEA
Middle Name:CHRISTINE
Last Name:MCKEOWN
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 WEST 95TH STREET
Mailing Address - Street 2:OUTPATIENT PAVILION, 6TH FLOOR
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:877-684-4327
Mailing Address - Fax:708-520-1871
Practice Address - Street 1:4400 W 95TH ST
Practice Address - Street 2:POB SUITE 407
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2654
Practice Address - Country:US
Practice Address - Phone:877-684-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009819364SA2200X
IL209-009819364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health