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General NPI Number Information
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NPI Number | 1558842849
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Entity Type | Organization
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Legal Business Name | REYES TUNG INC
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 28201 DIEHL RD
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City | WARRENVILLE
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State | IL
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Zip | 60555-3934
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Country | US
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Telephone | 630-836-8830
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Fax | 630-836-8832
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Provider Business Mailing Address
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Address Line | 3154 EVERGLADE AVE
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City | WOODRIDGE
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State | IL
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Zip | 60517-3315
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Country | US
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Telephone | 630-732-1438
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CATHERINE REYES
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Credential | OD
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Telephone | 630-732-1438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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