Provider Demographics
NPI:1982901658
Name:REAMS, MELISSA CATHERINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CATHERINE
Last Name:REAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 DEKALB AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-2736
Mailing Address - Country:US
Mailing Address - Phone:815-730-1800
Mailing Address - Fax:
Practice Address - Street 1:1715 DEKALB AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-2736
Practice Address - Country:US
Practice Address - Phone:815-730-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-011365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist