Provider Demographics
NPI:1861447484
Name:WEINSTEIN, RICHARD HARVEY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HARVEY
Last Name:WEINSTEIN
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 1:201 EAST HURON
Mailing Address - Street 2:SUITE 12-260 GALTER PAVILION
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-926-9570
Mailing Address - Fax:312-926-6776
Practice Address - Street 1:201 EAST HURON
Practice Address - Street 2:SUITE 12-260 GALTER PAVILION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-926-9570
Practice Address - Fax:312-926-6776
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics