Provider Demographics
NPI:1689287898
Name:REYES, CHERYL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17859 HEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3248
Mailing Address - Country:US
Mailing Address - Phone:773-398-7747
Mailing Address - Fax:
Practice Address - Street 1:20855 S LAGRANGE RD STE 200
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2040
Practice Address - Country:US
Practice Address - Phone:815-401-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical