Rena Lynn Fragale, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160004844 Issued in IL

Practice address

5050 S Lake Shore Dr
Apt 915
Chicago, IL 60615-3282

Phone

(281) 838-2139

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Rena Lynn Smyser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1144430240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 S LAKE SHORE DR",
            "address_2": "APT 915",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153282",
            "telephone_number": "281-838-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 S LAKE SHORE DR",
            "address_2": "APT 915",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153282",
            "telephone_number": "281-838-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGALE",
        "first_name": "RENA",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2060433",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENA",
            "last_name": "SMYSER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Elizabeth Fracol, M.D.
• Joel Edward Frader, MD
• Alec M Fradin
• Mira Fradkin, MSW, LSW
• Tyler J Fraga, MD
• Fletcher Fraher
• Kimberly Lay Fraher, M.ED., CCC-SLP
• Dustin Ryan Fraidenburg, M.D.
• Samantha Leigh Fraime, MD
• Kelsey Jordan Frain, APRN

• Physical Therapy Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.