Provider Demographics
NPI:1548321938
Name:REEB CENTER FOR WOUND MANAGEMENT
Entity type:Organization
Organization Name:REEB CENTER FOR WOUND MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:REEB
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:847-368-0918
Mailing Address - Street 1:325 W PROSPECT AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3141
Mailing Address - Country:US
Mailing Address - Phone:847-368-0916
Mailing Address - Fax:847-368-0919
Practice Address - Street 1:325 W PROSPECT AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3141
Practice Address - Country:US
Practice Address - Phone:847-368-0916
Practice Address - Fax:847-368-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001811163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL369940Medicare UPIN
1199280001Medicare NSC