Provider Demographics
NPI:1265738041
Name:RODNEY SCHAINIS MD LLC
Entity type:Organization
Organization Name:RODNEY SCHAINIS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY SCHAINIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHAINIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-5070
Mailing Address - Street 1:675 W NORTH AVE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1634
Mailing Address - Country:US
Mailing Address - Phone:708-450-5070
Mailing Address - Fax:708-450-5078
Practice Address - Street 1:675 W NORTH AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1634
Practice Address - Country:US
Practice Address - Phone:708-450-5070
Practice Address - Fax:708-450-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092883207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036092883Medicaid
IL036092883Medicaid