Healthcare Provider Details

I. General information

NPI: 1548485212
Provider Name (Legal Business Name): ROBERT CHRISTOPHER RINALDI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 BRYN MAWR AVE
ROSEMONT IL
60018-5701
US

IV. Provider business mailing address

2044 CANTERBURY PL
WHEATON IL
60189-8114
US

V. Phone/Fax

Practice location:
  • Phone: 847-233-4311
  • Fax:
Mailing address:
  • Phone: 630-690-4205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number0030C
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071003277
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number071003277
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: