Healthcare Provider Details

I. General information

NPI: 1669467130
Provider Name (Legal Business Name): KAREN D. REED O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN D. DUCKWORTH-REED O.D.

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6407 N ILLINOIS ST
FAIRVIEW HEIGHTS IL
62208-2720
US

IV. Provider business mailing address

6407 N ILLINOIS ST
FAIRVIEW HEIGHTS IL
62208-2720
US

V. Phone/Fax

Practice location:
  • Phone: 618-398-5005
  • Fax: 618-852-1930
Mailing address:
  • Phone: 618-398-5005
  • Fax: 618-852-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046011059
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: