Provider Demographics
NPI:1013229095
Name:REAMS, NICOLE DOROTHY (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:DOROTHY
Last Name:REAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 PFINGSTEN RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1339
Mailing Address - Country:US
Mailing Address - Phone:847-570-2570
Mailing Address - Fax:847-657-5708
Practice Address - Street 1:2180 PFINGSTEN RD STE 2000
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026
Practice Address - Country:US
Practice Address - Phone:847-570-2570
Practice Address - Fax:847-657-5708
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361377622084N0400X
MI4301097224390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program