Active NPI
John V. White, MD, LLC
- Vascular Surgery Physician
- Niles, IL
National Provider Identifier
1215251541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 036067291
- Legal business name
- JOHN V. WHITE, MD, LLC
- Practice address
- 8816 W Dempster St
Niles, IL 60714-5109 - Phone
- (847) 518-1762
- Fax
- (847) 723-3007
- NPI assigned
- Mar 15, 2010
- Reactivated
- Dec 1, 2010
- Last updated
- Dec 1, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Constance E Ryjewski, APN
- Title
- Office Manager
- Phone
- (847) 518-1762
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 036067291 | IL | Primary |
Addresses
Primary practice location
8816 W Dempster St
Niles, IL 60714-5109
Mailing address
8816 W Dempster St
Niles, IL 60714-5109
Phone (847) 518-1762
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036067291 | Medicaid | IL | |
| 0001632574 | Other | IL | BLUECROSS/BLUESHIELD |
National Provider Directory
National Provider DirectoryLocations
8816 W Dempster St
Niles, IL 60714
Phone (773) 321-2800
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Medical-Surgical Clinical Nurse Specialist
- Park Ridge, IL
- NPI 1861613507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1291161600000",
"number": "1215251541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8816 W DEMPSTER ST",
"city": "NILES",
"state": "IL",
"postal_code": "607145109",
"telephone_number": "847-518-1762",
"fax_number": "847-723-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8816 W DEMPSTER ST",
"city": "NILES",
"state": "IL",
"postal_code": "607145109",
"telephone_number": "847-518-1762",
"fax_number": "847-723-3007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHN V. WHITE, MD, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-15",
"last_updated": "2010-12-01",
"deactivation_date": "2010-04-05",
"reactivation_date": "2010-12-01",
"status": "A",
"authorized_official_last_name": "RYJEWSKI",
"authorized_official_first_name": "CONSTANCE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "847-518-1762",
"authorized_official_credential": "APN"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "IL",
"license": "036067291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036067291",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "0001632574",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.