Provider Demographics
NPI:1962475939
Name:FINKELSTEIN, GARY RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:RICHARD
Last Name:FINKELSTEIN
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 1:102 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364-2127
Mailing Address - Country:US
Mailing Address - Phone:815-672-4600
Mailing Address - Fax:815-672-3333
Practice Address - Street 1:102 W ELM ST
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-2127
Practice Address - Country:US
Practice Address - Phone:815-672-4600
Practice Address - Fax:815-672-3333
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073239207W00000X
IL036-073239207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC48426Medicare UPIN
ILK09734Medicare PIN