Individual
MR. REID M OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
154 LEONARD WOOD S APT 113, HIGHLAND PARK, IL 60035-5953
(847) 997-5867
(847) 681-1366
Mailing address
154 LEONARD WOOD S APT 113, HIGHLAND PARK, IL 60035-5953
(847) 997-5867
(847) 681-1366
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036046268
IL
208D00000X
General Practice Physician
Primary
036046268
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046268
—
IL
01
—
21608935
BCBS PROVIDER NUMBER
IL
01
—
791021783
RR MEDICARE NUMBER
IL
Enumeration date
08/30/2005
Last updated
05/10/2023
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