Provider Demographics
NPI:1952901506
Name:RILEY, JOAN KRISTEN (PHD, HCLD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:KRISTEN
Last Name:RILEY
Suffix:
Gender:F
Credentials:PHD, HCLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 CARDINAL TER
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1167
Mailing Address - Country:US
Mailing Address - Phone:314-607-7230
Mailing Address - Fax:
Practice Address - Street 1:259 E ERIE ST STE 2400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3907
Practice Address - Country:US
Practice Address - Phone:312-695-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist