Individual
MADELINE REAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3229 W 47TH PL, CHICAGO, IL 60632-3011
(773) 254-6044
Mailing address
1416 WOODS FARM LN, SPRINGFIELD, IL 62704-6431
(217) 414-6721
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010273
IL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/26/2022
Last updated
02/16/2024
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