Individual
JUSTIN REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
452 N EOLA RD, AURORA, IL 60502-9612
(630) 999-0401
(630) 423-9669
Mailing address
5338 N LATROBE AVE, CHICAGO, IL 60630-2206
(773) 682-0140
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-23908
IL
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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