Provider Demographics
NPI:1669481867
Name:REICH, WILLIAM PHILLIPS (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PHILLIPS
Last Name:REICH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 DUNDEE RD
Mailing Address - Street 2:SUITE 1702
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2727
Mailing Address - Country:US
Mailing Address - Phone:847-205-1222
Mailing Address - Fax:
Practice Address - Street 1:666 DUNDEE RD
Practice Address - Street 2:SUITE 1702
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2727
Practice Address - Country:US
Practice Address - Phone:847-205-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003232103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR18130Medicare UPIN