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General NPI Number Information
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NPI Number | 1215251541
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Entity Type | Organization
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Legal Business Name | JOHN V. WHITE, MD, LLC
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 8816 W DEMPSTER ST
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City | NILES
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State | IL
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Zip | 60714-5109
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Country | US
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Telephone | 847-518-1762
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Fax | 847-723-3007
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Provider Business Mailing Address
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Address Line | 8816 W DEMPSTER ST
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City | NILES
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State | IL
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Zip | 60714-5109
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Country | US
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Telephone | 847-518-1762
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Fax | 847-723-3007
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CONSTANCE E RYJEWSKI
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Credential | APN
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Telephone | 847-518-1762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036067291
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License Number State | IL
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