Katie Marie Reidy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006676 Issued in IL

Practice address

2701 Patriot Blvd
Glenview, IL 60026

Phone

(847) 475-2273

Fax

(847) 998-9005

NPI assigned

Jul 27, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1033696562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-475-2273",
            "fax_number": "847-998-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 S Waukegan Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600155239",
            "country_code": "US",
            "telephone_number": "312-926-6363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "870 N Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Vernon Hills",
            "state": "IL",
            "postal_code": "600611521",
            "country_code": "US",
            "telephone_number": "847-475-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDY",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betlhem Reda, PHARMD
• Janet Redden
• Himabindu Bellam Reddy, M.D.
• Ashley Redwine
• Regenerative Medicine Centers of America, LLC
• Samantha Simons Reidy, OTR/L
• Kaylie Ann Reinglass, MS
• Relive Physical Therapy LLC
• Relive Physical Therapy of Glenview, LLC
• Relive Physician Services LLC

• Physician Assistant in Glenview, IL
• Providers in Glenview, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.