Active NPI
Chantal R Reyna, M.D.
- Surgical Oncology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- 036163442
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 216-9000
- NPI assigned
- Jun 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | Q0350 | TX | |
| Surgical Oncology Physician | 2086X0206X | 35134346 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | LL1881 | NV | |
| Surgical Oncology Physician | 2086X0206X | 036163442 | IL | Primary |
| Surgery Physician | 208600000X | ME117508 | FL |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-5506
Other practice location 1
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6161
Other practice location 2
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340621701 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | creyna228907@direct.luhs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Surgical Oncology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000
Hospital & facility affiliations
- Loyola University Medical Center
- Loyola Gottlieb Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 28 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME117508 | FL | MD | Surgery Physician |
| 35134346 | OH | MD | Surgical Oncology Physician |
| LL1881 | NV | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Prospect Health Access Network, Inc. | Current | Accepting new patients | |
| Loyola University Medical Center | Current | Accepting new patients | |
| Prospect Health Access Network, Inc. | Current | Accepting new patients | |
| Prospect Health Access Network, Inc. | Current | Accepting new patients |
Locations
500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092
30 Lawrence Rd
Ste 700
Broomall, PA 19008
Phone (484) 446-3660
1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744
2100 Keystone Ave
Fl 1
Drexel Hill, PA 19026
Phone (610) 394-1840
100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- Emergency Medicine Physician
- Chester, PA
- NPI 1568819084
-
- Community/Retail Pharmacy
- Maywood, IL
- NPI 1184789299
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- Diagnostic Radiology Physician
- Chester, PA
- NPI 1154776797
-
- Maternal & Fetal Medicine Physician
- Chester, PA
- NPI 1154777837
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679356800000",
"number": "1902067697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 636256",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452636256",
"telephone_number": "513-585-5506",
"fax_number": "513-585-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [
{
"address_1": "1515 Holcombe Blvd",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770304000",
"country_code": "US",
"telephone_number": "713-792-6161",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1515 Holcombe Blvd",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770304000",
"country_code": "US",
"telephone_number": "713-792-6161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYNA",
"first_name": "CHANTAL",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2023-03-21",
"certification_date": "2023-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "TX",
"license": "Q0350",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "OH",
"license": "35134346",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NV",
"license": "LL1881",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "IL",
"license": "036163442",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME117508",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340621701",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "creyna228907@direct.luhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S 1st Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601533328",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.