MEDICARE: MRS. MARIA ISABEL REYES

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	222Q00000X	Developmental Therapist
2	225X00000X	Occupational Therapist	056003500	IL

General Provider Information

NPI Number	:	1376671115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA ISABEL REYES

Provider Business Mailing Address
First Line	:	2644 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3515
Country	:	US
Telephone Number	:	312-479-3258
Fax Number	:	773-523-2520

Provider Business Practice Location Address
First Line	:	2943 W 63RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2753
Country	:	US
Telephone Number	:	773-805-8314
Fax Number	:	773-523-2520

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	03/10/2026

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