Organization
JOHN V. WHITE, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE E RYJEWSKI APN (OFFICE MANAGER)
(847) 518-1762
Entity
Organization
Contact information
Practice address
8816 W DEMPSTER ST, NILES, IL 60714-5109
(847) 518-1762
(847) 723-3007
Mailing address
8816 W DEMPSTER ST, NILES, IL 60714-5109
(847) 518-1762
(847) 723-3007
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
036067291
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001632574
BLUECROSS/BLUESHIELD
IL
05
—
036067291
—
IL
Enumeration date
03/15/2010
Last updated
12/01/2010
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