Individual provider Active NPI

Kerrie Reed, M.D.

  • Rehabilitation Practitioner
  • Oak Park, IL
National Provider Identifier
1306914890
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
036102526 Issued in IL
Practice address
610 S Maple Ave
Suite 3420
Oak Park, IL 60304-1091
Phone
(708) 934-7100
Fax
(708) 934-7106
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 036102526 IL Primary

Addresses

Primary practice location

610 S Maple Ave
Suite 3420
Oak Park, IL 60304-1091

Mailing address

26W171 Roosevelt Rd
Wheaton, IL 60187-6078
Phone (630) 909-7000

Other identifiers 2

IdentifierTypeStateIssuer
036102526MedicaidIL
363236791OtherILTAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110429000363 IL Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 2264617695 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Integrative Healthcare, LTD CurrentSince Aug 29, 2013 Accepting new patients
Chicago Sports and Spine, LLC Past Accepting new patients
Rehab Medicine Clinic Past Accepting new patients
Schwab Faculty Associates Inc PastSince Mar 4, 2021 Accepting new patients
Rehabilitation Medicine Clinic, Inc. Rehabilitation Practitioner Past Accepting new patients

Locations

2731 N Lincoln Ave
Chicago, IL 60614
Phone (312) 520-3274

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1306914890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26W171 ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876078",
            "telephone_number": "630-909-7000",
            "fax_number": "630-909-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "SUITE 3420",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-934-7100",
            "fax_number": "708-934-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "KERRIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "IL",
            "license": "036102526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102526",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "363236791",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.