Patricia J Relleke

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209013774 Issued in IL

Practice address

916 Talon Dr
Suite 102
O Fallon, IL 62269-1848

Phone

(618) 628-8211

Fax

(618) 628-0883

NPI assigned

Jan 14, 2016

Last updated

Jan 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1770949125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELLEKE",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209013774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hasan Rehman
• Brian August Reichardt, M.D.
• Phebe Roseann Reifschneider, MS
• Kenneth G. Reinert, M.D.
• Ladonna Reives, BEHAVIOR TECHNICIAN
• Brooke Nicole Renspurger, MS, CF- SLP
• Replenishing Wellness, LLC
• Resilient Edge Therapy, PLLC
• Joshua Philip Reuss
• Kayla Revermann

• Adult Health Nurse Practitioner in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.