Provider Demographics
NPI:1932187259
Name:RINK, PETER C (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:C
Last Name:RINK
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 1:2300 53RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7564
Mailing Address - Country:US
Mailing Address - Phone:563-322-0971
Mailing Address - Fax:563-324-0615
Practice Address - Street 1:2300 53RD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7564
Practice Address - Country:US
Practice Address - Phone:563-322-0971
Practice Address - Fax:563-324-0615
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02423207X00000X
IL036092893207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8121085OtherBCBS
200029106OtherRR MEDICARE
042495OtherHEALTH ALLIANCE
IAIA0157OtherJOHN DEERE FAMILY
IA0001362Medicaid
IA58110OtherWELLMARK
1602936OtherFIRST HEALTH
IAIA0145OtherJOHN DEERE FAMILY
15605OtherMIDLANDS CHOICE
IA57864OtherWELLMARK
19912OtherIA HEALTH SOLUTIONS
IA58097OtherWELLMARK
IAT80928OtherJOHN DEERE FAMILY
E51165Medicare UPIN
15605OtherMIDLANDS CHOICE