Provider Demographics
NPI:1508858226
Name:VAINDER, JOHN MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARTIN
Last Name:VAINDER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:20 TOWER CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5711
Mailing Address - Country:US
Mailing Address - Phone:847-244-2960
Mailing Address - Fax:847-244-2986
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 505 WEST TOWER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-491-9020
Practice Address - Fax:847-491-0182
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2015-02-19
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Provider Licenses
StateLicense IDTaxonomies
IL036-057977207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43219Medicare UPIN