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NPI Code Detail

MEDICARE: MS. CHERYL REID

MEDICARE:  MS. CHERYL  REID
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
1172A00000XDriver

General Provider Information

NPI Number : 1770007775
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHERYL REID
Provider Business Mailing Address
First Line : 2304 W 80TH PL
Second Line :
City : CHICAGO
State : IL
Zip : 60620-5913
Country : US
Telephone Number : 773-419-3205
Fax Number :
Provider Business Practice Location Address
First Line : 2304 W 80TH PL
Second Line :
City : CHICAGO
State : IL
Zip : 60620-5913
Country : US
Telephone Number : 773-419-3205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2017
Last Update Date : 07/21/2022

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Directions to “ MS. CHERYL REID ” Practice Location

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