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Individual

KIM MICHAEL REICHERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 900, BELLEVILLE, IL 62223-5000
(618) 277-5700
(618) 257-7049

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
016-003257
IL
213ES0131X
Foot Surgery Podiatrist
Primary
016003257
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102179
HEALTHLINK
IL
01
4134729
AETNA
IL
01
480026528
RAILROAD MEDICARE PTAN
IL
01
601-15944
BC/BS
IL
01
STL2750010
UHC
Enumeration date
03/08/2006
Last updated
04/24/2012
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