Individual
MRS. TRUDE MARGARET REISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCA
Contact information
Practice address
300 E WAR MEMORIAL DRIVE, SUITE 202, PEORIA, IL 61614-7551
(309) 686-7250
(309) 686-7788
Mailing address
300 E WAR MEMORIAL DRIVE, SUITE 202, PEORIA, IL 61614-7551
(309) 686-7250
(309) 686-7788
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
68
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002134637001
CATERPILLAR
IL
01
—
07215173
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/07/2007
Last updated
07/08/2007
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