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Jennifer Reagan
Specialist in Lanark, Illinois
NPI 1033662416

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. You can also correspond with Jennifer Reagan through the mailing address at 201 IL ROUTE 64, LANARK, IL - 61046-8903 (mailing address contact number: 815-493-2321).

Location: 201 Il Route 64, Lanark, IL, 61046-8903
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
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
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Provider's Legacy Identifiers
Identifier Type State Issuer
3000006 01 IL DHS DDD MCO PLAN
7094638 01 IL DHS DDD BILLING AGENT
institution
Provider Business Practice Location Address Details
Address
201 Il Route 64
City
Lanark
State
Illinois
Zip
61046-8903
Phone Number
815-493-2321
Fax Number
person
Provider Business Mailing Address Details
Address
201 Il Route 64
City
Lanark
State
Illinois
Zip
61046-8903
Phone Number
815-493-2321
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
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.
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