Healthcare Provider Details

I. General information

NPI: 1407536295
Provider Name (Legal Business Name): RUTH REITER, LCSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S ROUTE 30 STE 204B
PLAINFIELD IL
60544-5688
US

IV. Provider business mailing address

2863 95TH ST STE 123-134
NAPERVILLE IL
60564-9005
US

V. Phone/Fax

Practice location:
  • Phone: 331-264-6002
  • Fax:
Mailing address:
  • Phone: 331-264-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RUTHANNE REITER
Title or Position: OWNER, LICENSED CLINICAL THERAPIST
Credential: LCSW
Phone: 331-264-6002