Healthcare Provider Details

I. General information

NPI: 1770087454
Provider Name (Legal Business Name): AUDRA JOYCE REITER MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD STE 5000
ARLINGTON HEIGHTS IL
60005-2384
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-3800
  • Fax: 847-618-3809
Mailing address:
  • Phone: 847-982-3175
  • Fax: 847-982-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036155497
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number84944-20
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: