Provider Demographics
NPI:1275057705
Name:REESE, CHRISTINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:LANG APPLEWHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR CHRISTINE REESE
Mailing Address - Street 1:18125 ROY ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-6628
Mailing Address - Country:US
Mailing Address - Phone:219-595-5964
Mailing Address - Fax:312-842-9550
Practice Address - Street 1:12247 S RACINE AVE
Practice Address - Street 2:
Practice Address - City:CALUMET PARK
Practice Address - State:IL
Practice Address - Zip Code:60643-5401
Practice Address - Country:US
Practice Address - Phone:312-687-0198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041757A103TC0700X
101YA0400X, 101YM0800X, 101YP1600X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1912992819OtherNPI
IN300056709Medicaid
IL1366075566OtherNPI
IN200136790Medicaid