Provider Demographics
NPI:1891728614
Name:REYES, MARGARET EMILIA (APN)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:EMILIA
Last Name:REYES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2423 S AUSTIN BLVD
Mailing Address - Street 2:ROOM 213
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-2616
Mailing Address - Country:US
Mailing Address - Phone:708-656-1130
Mailing Address - Fax:708-656-1129
Practice Address - Street 1:6258 N MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2806
Practice Address - Country:US
Practice Address - Phone:773-764-4165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41133677363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily