Provider Demographics
NPI:1558304733
Name:REINHART, GLENN A (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:A
Last Name:REINHART
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 1:4440 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2600
Mailing Address - Country:US
Mailing Address - Phone:708-684-4261
Mailing Address - Fax:
Practice Address - Street 1:9555 S 52ND AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3054
Practice Address - Country:US
Practice Address - Phone:708-684-4261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.084918207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1225084593OtherMEDICAL MUTUAL
OH273088817052OtherCARESOURCE
OH0892646OtherMEDICAID
OHP00875698OtherMEDICARE RAILROAD
OH2227110Medicaid
OH742492OtherBUCKEYE MEDICAID
OH1929640OtherGATEWAY HEALTH
OH681017OtherANTHEM
OH4238799OtherAETNA
KY64034911Medicaid
OH676792OtherBUCKEYE MEDICARE
OHJO0729377OtherMEDICARE
OH563852OtherWELCARE
KYK129140OtherMEDICARE
OHJO0729377OtherMEDICARE
OH2227110Medicaid