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NPI Code Detail

MEDICARE: DR. CASSIE JEAN REEVES OD

MEDICARE:  DR. CASSIE JEAN REEVES  OD
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
1152W00000XOptometrist046011097IL

General Provider Information

NPI Number : 1508394008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASSIE JEAN REEVES OD
Provider Business Mailing Address
First Line : 179 N CHICAGO ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-4126
Country : US
Telephone Number : 815-723-2020
Fax Number : 815-724-1505
Provider Business Practice Location Address
First Line : 1516 LEGACY CIR STE 102
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-1253
Country : US
Telephone Number : 630-245-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2017
Last Update Date : 03/17/2018

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Directions to “ DR. CASSIE JEAN REEVES OD” Practice Location

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