Active NPI
Rebekah Linnea Reid
- Developmental Therapist
- Loves Park, IL
National Provider Identifier
1124261714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.