Healthcare Provider Details

I. General information

NPI: 1285420653
Provider Name (Legal Business Name): JONAH RHYMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 S MICHIGAN AVE STE 8044
CHICAGO IL
60604-4434
US

IV. Provider business mailing address

332 S MICHIGAN AVE STE 8044
CHICAGO IL
60604-4434
US

V. Phone/Fax

Practice location:
  • Phone: 224-634-4734
  • Fax: 720-640-0405
Mailing address:
  • Phone: 224-634-4734
  • Fax: 720-640-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number213000470
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number211000418
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: