Provider Demographics
NPI:1255376836
Name:REIGN MANAGEMENT GROUP, INC.
Entity type:Organization
Organization Name:REIGN MANAGEMENT GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:VENUSO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-229-8400
Mailing Address - Street 1:6124 WEST 63RD STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638
Mailing Address - Country:US
Mailing Address - Phone:773-229-8400
Mailing Address - Fax:773-229-0155
Practice Address - Street 1:6124 WEST 63RD STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638
Practice Address - Country:US
Practice Address - Phone:773-229-8400
Practice Address - Fax:773-229-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010145251E00000X
IL1011297251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7658Medicare ID - Type Unspecified1010145