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NPI Code Detail

MEDICARE: LINDA REITER D.C.

MEDICARE:   LINDA  REITER  D.C.
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10004915293OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1659403400
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA REITER D.C.
Provider Business Mailing Address
First Line : 5415 BULL VALLEY RD
Second Line :
City : MCHENRY
State : IL
Zip : 60050-7410
Country : US
Telephone Number : 815-363-1163
Fax Number : 815-363-1164
Provider Business Practice Location Address
First Line : 5415 BULL VALLEY RD
Second Line :
City : MCHENRY
State : IL
Zip : 60050-7410
Country : US
Telephone Number : 815-363-1163
Fax Number : 815-363-1164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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