Provider Demographics
NPI:1184938672
Name:REYES, CATHERINE M (OD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:REYES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:REYES
Other - Last Name:TUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:310 S WEBER RD
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-5500
Practice Address - Country:US
Practice Address - Phone:703-847-8899
Practice Address - Fax:571-223-6780
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist