MEDICARE: DR. MARIA L REYES M.D.

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	208000000X	Pediatrics Physician	036-074084	IL

General Provider Information

NPI Number	:	1700895224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA L REYES M.D.

Provider Business Mailing Address
First Line	:	6649 W ARCHER AVE
Second Line	:	SUITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60638-2419
Country	:	US
Telephone Number	:	773-229-2373
Fax Number	:	773-229-2376

Provider Business Practice Location Address
First Line	:	7000 W ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2202
Country	:	US
Telephone Number	:	773-229-2373
Fax Number	:	773-229-2376

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	04/17/2023

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