Provider Demographics
NPI:1588151302
Name:RINELLA ORTHOTICS, INC.
Entity type:Organization
Organization Name:RINELLA ORTHOTICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-717-8970
Mailing Address - Street 1:1890 SILVER CROSS BLVD STE 255
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9528
Mailing Address - Country:US
Mailing Address - Phone:815-717-8970
Mailing Address - Fax:
Practice Address - Street 1:27W130 ROOSEVELT RD # 2E
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1611
Practice Address - Country:US
Practice Address - Phone:866-746-3552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RINELLA ORTHOTICS AND PROSTHETICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment