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General NPI Number Information
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NPI Number | 1982201463
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Entity Type | Individual
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Provider Name | LEILANI REYES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 4320 FIR ST UNIT 408
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City | EAST CHICAGO
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State | IN
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Zip | 46312-3078
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Country | US
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Telephone | 219-398-9265
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Fax | 219-398-9370
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Provider Business Mailing Address
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Address Line | 8558 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7032
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Country | US
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Telephone | 219-392-7084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.022049
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71013954A
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License Number State | IN
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