Individual
LEILANI REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4320 FIR ST UNIT 408, EAST CHICAGO, IN 46312-3078
(219) 398-9265
(219) 398-9370
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.022049
IL
363LF0000X
Family Nurse Practitioner
Primary
71013954A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300076366
—
IN
Enumeration date
10/07/2020
Last updated
01/07/2025
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