Jennifer Reagan is a Specialist based in Lanark, IL. Jennifer Reagan practices in Lanark, IL. The NPI Number for Jennifer Reagan is 1033662416 and holds a License No. 36-2663577 (Illinois).
The current practice location address for Jennifer Reagan is 201 Il Route 64, Lanark, IL and can be reached out via phone at 815-493-2321.
Location: 201 Il Route 64, Lanark, IL, 61046-8903
Provider Profile Details
NPI Number
1033662416
Provider Name
Jennifer Reagan
Credential
Provider Entity Type
Individual
Gender
Female
Address
201 Il Route 64, Lanark, IL, 61046-8903
Phone Number
815-493-2321
Fax Number
Provider Enumeration Date
08/02/2016
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3000006 | 01 | IL | DHS DDD MCO PLAN |
| 7094638 | 01 | IL | DHS DDD BILLING AGENT |
Provider Business Practice Location Address Details
Address
201 Il Route 64
City
State
Zip
61046-8903
Phone Number
815-493-2321
Fax Number
Provider Business Mailing Address Details
Address
201 Il Route 64
City
State
Zip
61046-8903
Phone Number
815-493-2321
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
36-2663577 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Badge
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