Provider Demographics
NPI:1780020438
Name:REYES, APRIL A (PTA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:A
Last Name:REYES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4869 N ELSTON AVE
Mailing Address - Street 2:STE #1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4869 N ELSTON AVE
Practice Address - Street 2:STE #1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2687
Practice Address - Country:US
Practice Address - Phone:773-526-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160006131225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant