# JOHN V. WHITE, MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215251541
- **Authorized official:** CONSTANCE E RYJEWSKI APN (OFFICE MANAGER)
- **Authorized official phone:** (847) 518-1762

## Contact information

- **Practice address:** 8816 W DEMPSTER ST, NILES, IL 60714-5109
- **Practice address phone:** (847) 518-1762
- **Practice address fax:** (847) 723-3007
- **Mailing address:** 8816 W DEMPSTER ST, NILES, IL 60714-5109
- **Mailing address phone:** (847) 518-1762
- **Mailing address fax:** (847) 723-3007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 036067291 | IL | Yes |

## Other

- **Enumeration date:** 03/15/2010
- **Last updated:** 12/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001632574 | BLUECROSS/BLUESHIELD | IL |
| 05 | — | 036067291 | — | IL |