Provider Demographics
NPI:1013400993
Name:REULAND, MICHAEL D (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:REULAND
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 E HILLCREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2470
Mailing Address - Country:US
Mailing Address - Phone:815-758-5508
Mailing Address - Fax:815-758-5537
Practice Address - Street 1:400 E HILLCREST DR STE 110
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2470
Practice Address - Country:US
Practice Address - Phone:815-758-5508
Practice Address - Fax:815-758-5537
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.023654208100000X
FLPT35527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation