Provider Demographics
NPI:1467523647
Name:REINHARD, CHRISTY GARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:GARRISON
Last Name:REINHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1605
Mailing Address - Country:US
Mailing Address - Phone:708-681-2298
Mailing Address - Fax:708-681-2398
Practice Address - Street 1:8321 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1605
Practice Address - Country:US
Practice Address - Phone:708-681-2298
Practice Address - Fax:708-681-2398
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH13742Medicare UPIN
367830Medicare PIN