Healthcare Provider Details

I. General information

NPI: 1114100393
Provider Name (Legal Business Name): MICHAEL J. REINSTEIN M.D PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 NORTH KENMORE AVE.
CHICAGO IL
60640-5015
US

IV. Provider business mailing address

8928 KILPATRICK AVE
SKOKIE IL
60076-1828
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-9868
  • Fax: 773-989-9824
Mailing address:
  • Phone: 773-989-9868
  • Fax: 773-989-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036041796
License Number StateIL

VIII. Authorized Official

Name: DR. MICHAEL J. REINSTEIN
Title or Position: SENIOR PARTNER
Credential: M.D.
Phone: 773-989-9868