Provider Demographics
NPI:1386989580
Name:REAVES, JOANNA ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:ELIZABETH
Last Name:REAVES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 N SANDBURG TER
Mailing Address - Street 2:APT 711 C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2075
Mailing Address - Country:US
Mailing Address - Phone:507-829-6804
Mailing Address - Fax:
Practice Address - Street 1:230 EAST OHIO STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3201
Practice Address - Country:US
Practice Address - Phone:312-274-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor