Healthcare Provider Details

I. General information

NPI: 1841767977
Provider Name (Legal Business Name): KATELYN REINHART APN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 FORD AVE
HOPEDALE IL
61747-9485
US

IV. Provider business mailing address

143 FORD AVE
HOPEDALE IL
61747-9485
US

V. Phone/Fax

Practice location:
  • Phone: 309-449-3336
  • Fax: 309-449-6001
Mailing address:
  • Phone: 309-449-3336
  • Fax: 309-449-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277001910
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: