MEDICARE: AUBREY REYNOLDS

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	106H00000X	Marriage & Family Therapist	166.001667	IL

General Provider Information

NPI Number	:	1619546868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUBREY REYNOLDS

Provider Business Mailing Address
First Line	:	909 W EUCLID AVE UNIT 1811
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1086
Country	:	US
Telephone Number	:	708-529-9229
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 W EUCLID AVE UNIT 1811
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1086
Country	:	US
Telephone Number	:	708-529-9229
Fax Number	:

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

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	12/03/2024

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Directions to “ AUBREY REYNOLDS ” Practice Location

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