Provider Demographics
NPI:1144294281
Name:JABAMONI, REENA (MD)
Entity type:Individual
Prefix:DR
First Name:REENA
Middle Name:
Last Name:JABAMONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 BARRINGTON RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1090
Mailing Address - Country:US
Mailing Address - Phone:847-843-7090
Mailing Address - Fax:847-843-0584
Practice Address - Street 1:1585 BARRINGTON RD
Practice Address - Street 2:SUITE 401
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1090
Practice Address - Country:US
Practice Address - Phone:847-843-7090
Practice Address - Fax:847-843-0584
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36046446207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL465430Medicare PIN
IL465432Medicare PIN
C41642Medicare UPIN