=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780733543
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SYDNEY REED LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2007
-----------------------------------------------------
Last Update Date | 01/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 820 DAVIS ST SUITE 218
-----------------------------------------------------
City | EVANSTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60201-4431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-866-7357
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1151 ASHLAND AVE
-----------------------------------------------------
City | EVANSTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60202-1140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-866-7357
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SYDNEY KAYE REED
-----------------------------------------------------
Credential | MSW
-----------------------------------------------------
Telephone | 847-866-7357
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------