Provider Demographics
NPI:1669481289
Name:RINER, GINA D (APN)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:D
Last Name:RINER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 N SEMINARY ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2852
Mailing Address - Country:US
Mailing Address - Phone:309-343-2262
Mailing Address - Fax:309-343-2081
Practice Address - Street 1:834 N SEMINARY ST
Practice Address - Street 2:SUITE 502
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2852
Practice Address - Country:US
Practice Address - Phone:309-343-2262
Practice Address - Fax:309-343-2081
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-006120363LP2300X
IL209006120363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL119067OtherHEALTH ALLIANCE PROVIDER#
IL209006120Medicaid
ILP00360459OtherRR MEDICARE PROV #
ILK31184Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER