Provider Demographics
NPI:1427036011
Name:RUBINSTEIN, WAYNE A (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:A
Last Name:RUBINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 DEMPSTER ST STE 625
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1137
Mailing Address - Country:US
Mailing Address - Phone:847-723-4088
Mailing Address - Fax:847-627-8700
Practice Address - Street 1:1875 DEMPSTER ST STE 625
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1137
Practice Address - Country:US
Practice Address - Phone:847-723-4088
Practice Address - Fax:847-627-8700
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-075584174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-075584Medicaid
ILL87226Medicare PIN