Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 209.006459 | IL |
NPI | 1164798641 |
---|---|
Provider Name | Kate M Reed |
First Address | South Elgin, IL 60177-3202 |
Second Address | South Elgin, IL 60177-3202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 28/03/2012 |