Basic Information
| Provider Information | |||||||||
| NPI: | 1548846975 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REILAND | ||||||||
| FirstName: | HALEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 READING DR APT 1213 | ||||||||
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| City: | MONTGOMERY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605382906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3312034092 | ||||||||
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| Practice Location | |||||||||
| Address1: | 29 STONEHILL RD STE D | ||||||||
| Address2: | |||||||||
| City: | OSWEGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605439449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883083728 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2021 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 056.014013 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.