Provider Demographics
NPI:1669438487
Name:REHBEIN, CYNTHIA J (OD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:REHBEIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELOIT HEALTH SYSTEM INC
Mailing Address - Street 2:1905 E HUEBBE PARKWAY
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-1842
Mailing Address - Country:US
Mailing Address - Phone:608-364-2293
Mailing Address - Fax:608-384-5452
Practice Address - Street 1:BELOIT HEALTH SYSTEM INC
Practice Address - Street 2:1905 E HUEBBE PARKWAY
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1842
Practice Address - Country:US
Practice Address - Phone:608-364-2293
Practice Address - Fax:608-384-5452
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2660-035152W00000X
WI2660-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38608800Medicaid
WI7386OtherDEAN HEALTH INSURANCE
WIK400112221Medicare PIN
WI7386OtherDEAN HEALTH INSURANCE
U64683Medicare UPIN
WI410043376Medicare PIN