| Reginald Spears Md Llc | |
|
4160 Route 83 Suite 207 Long Grove IL 60047 | |
| (847) 415-2127 | |
| (847) 415-2130 |
| Full Name | Reginald Spears Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4160 Route 83, Long Grove, Illinois |
| Authorized Official Name and Position | Reginald Spears (OWNER) |
| Authorized Official Contact | 8474152127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reginald Spears Md Llc 4160 Route 83 Suite 207 Long Grove IL 60047 Ph: (847) 415-2127 | Reginald Spears Md Llc 4160 Route 83 Suite 207 Long Grove IL 60047 Ph: (847) 415-2127 |
| NPI Number | 1467626168 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Medicare PECOS PAC ID | 4385548296 |
|---|---|
| Medicare Enrollment ID | O20031121000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467626168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
| Provider Name | Reginald Spears |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861485153 PECOS PAC ID: 3072417989 Enrollment ID: I20031209000504 |
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