Active NPI
Jordan Reif
- Physician Assistant
- McHenry, IL
National Provider Identifier
1801313143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1409 Eastwood Lane
McHenry, IL 60051 - Phone
- (815) 354-1396
- NPI assigned
- Aug 28, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Athletic Trainer | 2255A2300X |
Addresses
Primary practice location
1409 Eastwood Lane
McHenry, IL 60051
Mailing address
1409 Eastwood LN
McHenry, IL 60051-4611
Phone (815) 354-1396
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": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1801313143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 EASTWOOD LN",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600514611",
"telephone_number": "815-354-1396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 EASTWOOD LANE",
"city": "MCHENRY",
"state": "IL",
"postal_code": "60051",
"telephone_number": "815-354-1396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIF",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-28",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.