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General NPI Number Information
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NPI Number | 1093979122
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Entity Type | Organization
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Legal Business Name | JOHN W. RINKER
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 1515 W REYNOLDS ST
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City | PONTIAC
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State | IL
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Zip | 61764-9673
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Country | US
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Telephone | 815-842-3381
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Fax | 815-842-2054
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Provider Business Mailing Address
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Address Line | 1515 W REYNOLDS ST
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City | PONTIAC
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State | IL
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Zip | 61764-9673
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Country | US
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Telephone | 815-842-3381
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Fax | 815-842-2054
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Authorized Official
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Title or Position | OWNER
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Name | JOHN W RINKER
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Credential | DO
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Telephone | 815-842-3381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036074643
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License Number State | IL
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