DR. LANCE DAVID REINKE (NPI# 1689808750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689808750 |
| Entity Type | Individual |
| Full Name | DR. LANCE DAVID REINKE |
| Credential | PSY.D. |
| Practice Address |
2445 Dean St Ste 1a St Charles IL 60175-4828 |
| Practice Telephone | 6309334662 |
| Practice Fax Number | 6309384697 |
| Mailing Telephone | 6309334662 |
| Mailing Fax Number | 6309384697 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2015-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 071007671 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071007671 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2445 DEAN ST STE 1A |
| City | ST CHARLES |
| State | IL |
| Zip Code | 60175-4828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733138 | Ryan Paul Kuebler | Dentist | 40w320 La Fox Rd., Suite D, St Charles, IL 60175 | 2016-08-02 |
| 1346602554 | Erica Witkowski | Specialist/Technologist | 6n 370 Crescent Lane, Saint Charles, IL 60175 | 2016-03-26 |
| 1437495728 | Bradley S Murison | Physical Therapist | 3381 W State St., Suite 100, St Charles, IL 60175 | 2012-12-14 |
| 1942507355 | Fox River & Countryside Fire/rescue District | Ambulance | 35w350 Carl Lee Road, St Charles, IL 60175 | 2011-02-21 |
| 1871825984 | Fay E Jackson | Counselor | 3140 W Route 64, St. Charles, IL 60175 | 2010-02-01 |
| 1801126941 | Philip James Kocisko | Counselor | 3140 W. Route 64, Saint Charles, IL 60175 | 2010-01-13 |
| 1891971529 | Caroline M Bollentino | Speech-Language Pathologist | 40w310 La Fox Rd, Suite A1-b1, St Charles, IL 60175 | 2008-01-11 |
| 1770783599 | Joy O Urubusi | Psychiatry & Neurology | 3825 Campton Hills Road, St Charles, IL 60175 | 2007-07-19 |
| 1225236052 | Anna Almase Medina | Dentist | 2445 Dean, 1c, St Charles, IL 60175 | 2007-07-03 |
| 1467666453 | Shelly Sinatra | Nurse Practitioner | 3310 W. Main St, Suite 200, St. Charles, IL 60175 | 2007-05-09 |
| Find all providers in zip 60175 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669812756 | Axiscare Neuropsychology, LLC | Clinical Neuropsychologist | 2580 Foxfield Rd Ste 101-4, St Charles, IL 60174-1403 | 2013-07-03 |
| 1114040227 | Susan Christine Valessares | Clinical Neuropsychologist | 3 Squire Ln, St Charles, IL 60174-1413 | 2007-04-06 |
| 1063585933 | Neal Ross Bowen | Clinical Neuropsychologist | 2580 Foxfield Rd, Ste 101-4, St Charles, IL 60174-1403 | 2006-11-16 |
| 1104292820 | Nina Appadurai | Clinical Neuropsychologist | 2580 Foxfield Rd Ste 101-4, St Charles, IL 60174-1403 | 2015-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
| 1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
| 1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
| 1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
| 1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
| 1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
| Find all providers with the same taxonomy | ||||
| City | ST CHARLES |
| Zip Code | 60175 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.