Healthcare Provider Details

I. General information

NPI: 1154316792
Provider Name (Legal Business Name): MICHAEL JAY REINSTEIN PSYCHIATRIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8928 KILPATRICK AVE
SKOKIE IL
60076-1828
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:
Title or Position:
Credential:
Phone: