Provider Demographics
NPI:1568525004
Name:RHEINSTROM, STEPHEN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DAVID
Last Name:RHEINSTROM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 RICE ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5011
Mailing Address - Country:US
Mailing Address - Phone:847-433-3342
Mailing Address - Fax:847-433-3342
Practice Address - Street 1:641 RICE ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5011
Practice Address - Country:US
Practice Address - Phone:847-433-3342
Practice Address - Fax:847-433-3342
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-057560207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036057560Medicaid
ILC39119Medicare UPIN
IL645220Medicare PIN