Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1366069585 |
---|---|
Provider Name | Dr. Patricia Marie Reyes |
First Address | Elmhurst, IL 60126-2135 |
Second Address | Elmhurst, IL 60126-2135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2020 |
Last Update Date | 03/07/2020 |