Individual
TESIA REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1469 STARFISH LN, SYCAMORE, IL 60178-8621
(773) 968-2152
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 306-9001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-011470
IL
152W00000X
Optometrist
3890-35
WI
152W00000X
Optometrist
OEG004021
PA
152W00000X
Optometrist
OPT-002688
AZ
152W00000X
Optometrist
OPT-OPT-LIC-3977
MT
152W00000X
Optometrist
TPOP67
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046011470
—
IL
Enumeration date
04/02/2019
Last updated
06/27/2023
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