Individual provider Active NPI

Rebekah Linnea Reid

  • Developmental Therapist
  • Loves Park, IL
National Provider Identifier
1124261714
Registry record updated Apr 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
1752 Windsor Rd
Loves Park, IL 61111-4280
Phone
(815) 654-6170
NPI assigned
Apr 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

1752 Windsor Rd
Loves Park, IL 61111-4280

Mailing address

10177 Metalmark LN
Unit #4
Roscoe, IL 61073-5685
Phone (815) 978-4982

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

NPI Registry JSON

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

{
    "created_epoch": "1239494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239494400000",
    "number": "1124261714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10177 METALMARK LN",
            "address_2": "UNIT #4",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610735685",
            "telephone_number": "815-978-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 WINDSOR RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114280",
            "telephone_number": "815-654-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "REBEKAH",
        "middle_name": "LINNEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-12",
        "last_updated": "2009-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2009; 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.