Healthcare Provider Details

I. General information

NPI: 1285544908
Provider Name (Legal Business Name): REVERIE THERAPY GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 BRIAR GLEN CT
HAMPSHIRE IL
60140-1031
US

IV. Provider business mailing address

1 E ERIE ST STE 525-4513
CHICAGO IL
60611-2740
US

V. Phone/Fax

Practice location:
  • Phone: 847-903-2216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE CAMPAGNA
Title or Position: OWNER
Credential:
Phone: 847-903-2216