Individual
DR. JOHN THOMAS REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
630 TERRA WEST DR, FREEPORT, IL 61032-4536
(815) 235-7858
(815) 235-7913
Mailing address
630 TERRA WEST DR, FREEPORT, IL 61032-4536
(815) 235-7858
(815) 235-7913
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004932381
BC/BS
IL
01
—
2017038
FIRST HEALTH
IL
01
—
3474535
AETNA - HMO
IL
01
—
5979340
CIGNA
IL
01
—
7531336
AETNA - PPO
IL
Enumeration date
09/22/2005
Last updated
11/27/2012
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