MEDICARE: JENNIFER REED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180.003994	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180.003994	OTHER	IL	IL LICENSE

General Provider Information

NPI Number	:	1093167678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER REED

Provider Business Mailing Address
First Line	:	220 W MAIN ST
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2156
Country	:	US
Telephone Number	:	815-223-0160
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 W MAIN ST
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2156
Country	:	US
Telephone Number	:	312-203-8108
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	04/11/2022

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Directions to “ JENNIFER REED ” Practice Location

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