Mary Elizabeth Reynolds, M.A., MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1036 Elgin Ave
1St Floor
Forest Park, IL 60130-2856

Phone

(773) 988-4952

Fax

(630) 540-9366

NPI assigned

Sep 25, 2007

Last updated

Sep 25, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1053507988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 ELGIN AVE",
            "address_2": "1ST FLOOR",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302856",
            "telephone_number": "773-988-4952",
            "fax_number": "630-540-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 ELGIN AVE",
            "address_2": "1ST FLOOR",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302856",
            "telephone_number": "773-988-4952",
            "fax_number": "630-540-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "M.A., MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.