Provider Demographics
NPI:1629669379
Name:REITER, RUTHANNE E (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:RUTHANNE
Middle Name:E
Last Name:REITER
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2863 95TH ST STE 123-134
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9005
Mailing Address - Country:US
Mailing Address - Phone:331-264-6002
Mailing Address - Fax:
Practice Address - Street 1:13550 S ROUTE 30 STE 204B
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5688
Practice Address - Country:US
Practice Address - Phone:331-264-6002
Practice Address - Fax:331-264-4291
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0219091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical