Individual provider Active NPI

Stephen David Rheinstrom, M.D.

  • Ophthalmology Physician
  • Highland Park, IL
National Provider Identifier
1568525004
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-057560 Issued in IL
Practice address
641 Rice St
Highland Park, IL 60035-5011
Phone
(847) 433-3342
Fax
(847) 433-3342
NPI assigned
Dec 18, 2006
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036-057560 IL Primary

Addresses

Primary practice location

641 Rice St
Highland Park, IL 60035-5011

Mailing address

641 Rice St
Highland Park, IL 60035-5011
Phone (847) 433-3342

Other practice location 1

4709 Golf Rd Ste 107
Skokie, IL 60076-1231
Phone (847) 674-4363

Other identifiers 1

IdentifierTypeStateIssuer
036057560MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000318 IL Practitioner - Ophthalmology 5092989657 Practice locations: Chicago, IL; Northbrook, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-057560ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Selvaraj Ophthalmology LLC CurrentSince Jun 1, 2021 Accepting new patients
BJG MD SC PastSince Mar 1, 2020 Accepting new patients
Bertram Kraft, MD, SC Ophthalmology PastSince Jun 1, 2021 Accepting new patients

Locations

111 N Wabash Ave
Ste 1610
Chicago, IL 60602
Phone (312) 263-6350

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1568525004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 RICE ST",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355011",
            "telephone_number": "847-433-3342",
            "fax_number": "847-433-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 RICE ST",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355011",
            "telephone_number": "847-433-3342",
            "fax_number": "847-433-3342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4709 Golf Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600761231",
            "country_code": "US",
            "telephone_number": "847-674-4363",
            "fax_number": "847-674-4387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHEINSTROM",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-057560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057560",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.