Provider Demographics
NPI:1821121864
Name:WINTERNHEIMER, GEORGE EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EDWARD
Last Name:WINTERNHEIMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 W CERMAK
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2151
Mailing Address - Country:US
Mailing Address - Phone:708-795-7040
Mailing Address - Fax:708-795-5664
Practice Address - Street 1:7008 W CERMAK
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2151
Practice Address - Country:US
Practice Address - Phone:708-795-7040
Practice Address - Fax:708-795-5664
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL383305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
445820Medicare ID - Type Unspecified
1615827Medicare UPIN