Individual provider Active NPI

Matthew Reeb, PHARMD

  • Pharmacist
  • Peoria, IL
National Provider Identifier
1083214027
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051287713 Issued in IL
Practice address
8915 N Allen Rd
Peoria, IL 61615-1534
Phone
(309) 693-9854
Fax
(309) 693-9862
NPI assigned
Oct 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051287713 IL Primary

Addresses

Primary practice location

8915 N Allen Rd
Peoria, IL 61615-1534

Mailing address

1415 Brookcrest Ave
Morton, IL 61550-3111
Phone (309) 369-5473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051287713ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1083214027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BROOKCREST AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503111",
            "telephone_number": "309-369-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151534",
            "telephone_number": "309-693-9854",
            "fax_number": "309-693-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEB",
        "first_name": "MATTHEW",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051287713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.