Provider Demographics
NPI:1184408957
Name:REED, LAKEISHA
Entity type:Individual
Prefix:MS
First Name:LAKEISHA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 CARMEL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-3111
Mailing Address - Country:US
Mailing Address - Phone:844-244-1410
Mailing Address - Fax:224-442-2810
Practice Address - Street 1:2214 CARMEL BLVD
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-3111
Practice Address - Country:US
Practice Address - Phone:844-244-1410
Practice Address - Fax:224-442-2810
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL372500000X, 372600000X, 3747P1801X, 376J00000X, 385H00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care