Healthcare Provider Details

I. General information

NPI: 1891065561
Provider Name (Legal Business Name): VICTORIA REID PHD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD STE 200
OAK BROOK IL
60523-1370
US

IV. Provider business mailing address

2021 MIDWEST RD STE 200
OAK BROOK IL
60523-1370
US

V. Phone/Fax

Practice location:
  • Phone: 708-403-4055
  • Fax: 708-261-0711
Mailing address:
  • Phone: 708-403-4055
  • Fax: 708-261-0711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number071005245
License Number StateIL

VIII. Authorized Official

Name: VICTORIA REID
Title or Position: PRESIDENT
Credential:
Phone: 708-478-2372