Provider Demographics
NPI:1083045785
Name:JOANNA REAVES DC, LTD
Entity Type:Organization
Organization Name:JOANNA REAVES DC, LTD
Other - Org Name:REAVES CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-767-6600
Mailing Address - Street 1:500 N DEARBORN ST
Mailing Address - Street 2:STE 700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654
Mailing Address - Country:US
Mailing Address - Phone:313-767-6600
Mailing Address - Fax:312-767-6601
Practice Address - Street 1:500 N DEARBORN ST
Practice Address - Street 2:STE 700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654
Practice Address - Country:US
Practice Address - Phone:312-767-6600
Practice Address - Fax:312-767-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty