Healthcare Provider Details

I. General information

NPI: 1457291171
Provider Name (Legal Business Name): KATHLEEN DOROTHY REITMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16310 S LINCOLN HWY
PLAINFIELD IL
60586-9006
US

IV. Provider business mailing address

16310 S LINCOLN HWY
PLAINFIELD IL
60586-9006
US

V. Phone/Fax

Practice location:
  • Phone: 815-782-8440
  • Fax: 815-926-5305
Mailing address:
  • Phone: 815-782-8440
  • Fax: 815-926-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.034316
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: