Provider Demographics
NPI:1407828940
Name:REYES, CHRISTOPHER D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5383 STATE ROUTE 154
Mailing Address - Street 2:
Mailing Address - City:PINCKNEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62274-3342
Mailing Address - Country:US
Mailing Address - Phone:618-357-2131
Mailing Address - Fax:618-357-3411
Practice Address - Street 1:5383 STATE ROUTE 154
Practice Address - Street 2:
Practice Address - City:PINCKNEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62274-3342
Practice Address - Country:US
Practice Address - Phone:618-357-2131
Practice Address - Fax:618-357-3411
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100192207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0027340094OtherBCBS PHYS PROVIDER #
IL051108OtherHEALTH ALLIANCE ID
IL036100192Medicaid
IL110225333OtherMEDICARE RAILROAD
IL7320380OtherBCBS FMC GROUP PROVIDER #
IL2086975OtherUNITED HEALTHCARE ID
IL420618OtherHEALTHLINK PROVIDER ID
ILH01276Medicare UPIN
IL420618OtherHEALTHLINK PROVIDER ID