id Provider Date Of Birth File Name File Expiration Date Notes Email
PDF 3 Reed, Jody 01/29/1971 Complete credentialing Packet Open
PDF 11 Reed, Jody 01/29/1971 State Release Open
PDF 27 Reed, Jody 01/29/1971 Licensed Physician Controlled Substance Open 07/31/2023
PDF 4 Reed, Jody 01/29/1971 DEA Open 04/30/2022 jodyreed@physiciancare.net
PDF 12 Reed, Jody 01/29/1971 Photograph Open
PDF 29 Reed, Jody 01/29/1971 Licensed Physician and Surgeon Open 07/31/2023 Jodyreed@physiciancare.net
PDF 5 Reed, Jody 01/29/1971 Driving Licence Open
PDF 13 Reed, Jody 01/29/1971 State ID Open
PDF 30 Reed, Jody 01/29/1971 PROFESSIONAL / LIABILITY Open 11/08/2021 Iqra@physiciancare.net
PDF 6 Reed, Jody 01/29/1971 Certificate of Residency Open
PDF 14 Reed, Jody 01/29/1971 Illinicare Disclosure of Ownership Open
PDF 7 Reed, Jody 01/29/1971 Copy Of Diploma Open
PDF 15 Reed, Jody 01/29/1971 VOID CHQ Open
PDF 8 Reed, Jody 01/29/1971 Internship Open
PDF 16 Reed, Jody 01/29/1971 Provider Information Sheet Open
PDF 9 Reed, Jody 01/29/1971 Roseland Credentialling Application Open
PDF 25 Reed, Jody 01/29/1971 CIGNA ERA ENROLLMENT FORM Open
PDF 1 Reed, Jody 01/29/1971 Mal practice Insurance Open 11/08/2020 jodyreed@physiciancare.net
PDF 10 Reed, Jody 01/29/1971 Resume Open
PDF 18 Reed, Jody 01/29/1971 EFT Setup signed forms Open
PDF 26 Reed, Jody 01/29/1971 LICENSED PHYSICIAN AND SURGEON Open 09/30/2020
PDF 19 Wanyana, Christine 04/28/1980 APN License Open
PDF 20 Wanyana, Christine 04/28/1980 APN Controlled License Open
PDF 21 Wanyana, Christine 04/28/1980 CNP Certificate Open
PDF 22 Wanyana, Christine 04/28/1980 Resume Open
PDF 23 Wanyana, Christine 04/28/1980 Professional Liability Insurance Open 08/09/2020
PDF 24 Wanyana, Christine 04/28/1980 DEA Certificate Open 05/31/2023
PDF 17 Wanyana, Christine 04/28/1980 DEA Open 05/31/2023