Provider Demographics
NPI:1922444504
Name:REED, MICHAEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:REED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 WASHINGTON ST
Mailing Address - Street 2:STE. 200B
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-4983
Mailing Address - Country:US
Mailing Address - Phone:847-791-4830
Mailing Address - Fax:855-301-9794
Practice Address - Street 1:2504 WASHINGTON ST
Practice Address - Street 2:STE. 200B
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4983
Practice Address - Country:US
Practice Address - Phone:847-791-4830
Practice Address - Fax:855-301-9794
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor