MEDICARE: MS. PATTI J REID LCPC

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	101YP2500X	Professional Counselor	180006696	IL

General Provider Information

NPI Number	:	1922268499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATTI J REID LCPC

Provider Business Mailing Address
First Line	:	106 N MAIN ST
Second Line	:
City	:	WAUCONDA
State	:	IL
Zip	:	60084-1824
Country	:	US
Telephone Number	:	847-687-1846
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 N WILKE RD
Second Line	:	STE 160
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1278
Country	:	US
Telephone Number	:	847-687-1846
Fax Number	:

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	04/13/2009

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