Individual
DR. GREGORY D RECKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1307 W WASHINGTON ST, OREGON, IL 61061
(815) 732-3151
(815) 732-3718
Mailing address
1307 W WASHINGTON ST, OREGON, IL 61061-1022
(815) 732-3151
(815) 732-3718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-098001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098001
—
IL
01
—
L65546
MEDICARE PTAN
IL
Enumeration date
03/08/2006
Last updated
09/04/2018
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