Provider Demographics
NPI:1275635757
Name:REED, DEBORAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:REED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WESTMINSTER PL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-5511
Mailing Address - Country:US
Mailing Address - Phone:847-295-4248
Mailing Address - Fax:
Practice Address - Street 1:1 WESTMINSTER PL
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-5511
Practice Address - Country:US
Practice Address - Phone:847-295-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0692932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL201633Medicare ID - Type Unspecified
ILC-64511Medicare UPIN