Individual
DERRICK REUBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4108 APPLEWOOD LN, MATTESON, IL 60443-1903
(708) 699-5078
Mailing address
4108 APPLEWOOD LN, MATTESON, IL 60443-1903
(708) 699-5078
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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