Healthcare Provider Details

I. General information

NPI: 1548186588
Provider Name (Legal Business Name): JUSTINE LOUISE REENTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 S BROADWAY ST
COAL CITY IL
60416-1705
US

IV. Provider business mailing address

695 S BROADWAY ST
COAL CITY IL
60416-1705
US

V. Phone/Fax

Practice location:
  • Phone: 815-821-6101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.116432
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: