Provider Demographics
NPI:1942525878
Name:REINHART, NICHOLAS RYAN (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RYAN
Last Name:REINHART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W. PARK ST
Mailing Address - Street 2:FAPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801
Mailing Address - Country:US
Mailing Address - Phone:121-790-2529
Mailing Address - Fax:
Practice Address - Street 1:101 SOUTH MAJOR STREET
Practice Address - Street 2:101 SOUTH MAJOR STREET
Practice Address - City:EUREKA
Practice Address - State:IL
Practice Address - Zip Code:61530
Practice Address - Country:US
Practice Address - Phone:309-467-4145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-04
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.132772207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine