Provider Demographics
NPI:1871572867
Name:RINEHART, JOHN S (MD PHD JD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:RINEHART
Suffix:
Gender:M
Credentials:MD PHD JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 RIDGE AVE
Mailing Address - Street 2:#200
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2455
Mailing Address - Country:US
Mailing Address - Phone:847-869-7777
Mailing Address - Fax:847-869-7782
Practice Address - Street 1:2500 RIDGE AVE
Practice Address - Street 2:#200
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2455
Practice Address - Country:US
Practice Address - Phone:847-869-7777
Practice Address - Fax:847-869-7782
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36072936207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B76447Medicare UPIN
IL211330Medicare ID - Type Unspecified