Reynolds, Erica Marie

Reynolds, Erica Marie is an individual health care provider with primary practice located at 350 N Wall St , Kankakee IL 60901-2901. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Reynolds, Erica Marie can be contacted via phone (815) 935-7514.

Contact Information

Primary practice address
350 N Wall St Kankakee IL 60901-2901
Phone: (815) 935-7514
Fax: (815) 935-7069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05007435A Indiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070.014188 Illinois

Profile Details

NPI number 1134189293
LBN Legal business name Reynolds, Erica Marie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Nov 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134189293 NPPES
Indiana Other 000000219707 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 200364140 ANTHEM PROVIDER NUMBER

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