Provider Demographics
NPI:1912974098
Name:REUSS, ALAN D (PT)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:REUSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 S FRONTAGE RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5830
Mailing Address - Country:US
Mailing Address - Phone:630-920-4670
Mailing Address - Fax:630-920-4689
Practice Address - Street 1:1441 ESSINGTON RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2873
Practice Address - Country:US
Practice Address - Phone:815-744-6666
Practice Address - Fax:815-744-5559
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11471225100000X
IL070016416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist