MEDICARE: REED ALLEN M.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		IL

General Provider Information

NPI Number	:	1275016727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REED ALLEN M.ED.

Provider Business Mailing Address
First Line	:	3416 N ELAINE PL APT 3E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-2445
Country	:	US
Telephone Number	:	815-545-3778
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 E LAKE ST SIDE 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-5913
Country	:	US
Telephone Number	:	773-242-9736
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	09/11/2018

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