Individual
CRISTAL REIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
21202 OWENS RD STE 101, MOKENA, IL 60448-2038
(779) 334-0030
(779) 334-0031
Mailing address
21202 OWENS RD STE 101, MOKENA, IL 60448-2038
(779) 334-0030
(779) 334-0031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28220363A
IN
363L00000X
Nurse Practitioner
Primary
209022335
IL
363LF0000X
Family Nurse Practitioner
71010694A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300098489
—
IN
Enumeration date
11/13/2020
Last updated
11/25/2024
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