Provider Demographics
NPI:1598985913
Name:REIF, KIMBERLY (DT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:REIF
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6143 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2917
Mailing Address - Country:US
Mailing Address - Phone:708-341-2235
Mailing Address - Fax:
Practice Address - Street 1:26926 W HEMLOCK RD
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-3391
Practice Address - Country:US
Practice Address - Phone:630-267-5325
Practice Address - Fax:815-467-0257
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist