Provider Demographics
NPI:1427023415
Name:REED, DONALD LYNN (DC, L AC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LYNN
Last Name:REED
Suffix:
Gender:M
Credentials:DC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2715
Mailing Address - Country:US
Mailing Address - Phone:773-881-0888
Mailing Address - Fax:773-881-8182
Practice Address - Street 1:3301 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2715
Practice Address - Country:US
Practice Address - Phone:773-881-0888
Practice Address - Fax:773-881-8182
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000182171100000X
IL038004424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1682532OtherBLUE CROSS BLUE SHIELD
IL1682532OtherBLUE CROSS BLUE SHIELD
683950Medicare ID - Type Unspecified