1114100393 NPI number — MICHAEL J. REINSTEIN M.D PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114100393 NPI number — MICHAEL J. REINSTEIN M.D PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL J. REINSTEIN M.D PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY MENTAL HEALTH SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114100393
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8928 KILPATRICK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SKOKIE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60076-1828
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-989-9868
Provider Business Mailing Address Fax Number:
773-989-9824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4755 NORTH KENMORE AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60640-5015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-989-9868
Provider Business Practice Location Address Fax Number:
773-989-9824
Provider Enumeration Date:
12/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REINSTEIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
SENIOR PARTNER
Authorized Official Telephone Number:
773-989-9868

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  036041796 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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