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General NPI Number Information
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NPI Number | 1962370528
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Entity Type | Organization
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Legal Business Name | REAVILLMED, LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 253 N JACKSON ST
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City | FRANKFORT
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State | IN
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Zip | 46041-1936
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Country | US
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Telephone | 815-483-5712
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 PEBBLE BEACH DR
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City | PLAINFIELD
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State | IL
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Zip | 60586-8385
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Country | US
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Telephone | 815-483-5712
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW REAVILL
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Credential |
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Telephone | 815-483-5712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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