Provider Demographics
NPI:1245241983
Name:STEIN, REGINA MICHELLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MICHELLE
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:REGINA
Other - Middle Name:MICHELLE
Other - Last Name:GANDICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25068 NETWORK PL
Mailing Address - Street 2:HEMATOLOGY ONCOLOGY ASSOCIATES OF IL LLC
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-0001
Mailing Address - Country:US
Mailing Address - Phone:847-585-7000
Mailing Address - Fax:847-240-0622
Practice Address - Street 1:676 N ST CLAIR ST
Practice Address - Street 2:SUITE 2140
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-664-5400
Practice Address - Fax:312-664-5854
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111761207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00427787Medicare PIN
ILK38338Medicare PIN