MEDICARE: DR. TROY D ECKMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	036102265	IL
2	207V00000X	Obstetrics & Gynecology Physician	91829	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5530096	OTHER	IL	BLUE CROSS/BLUE SHIELD
4	059558	OTHER	IL	HEALTH ALLIANCE

General Provider Information

NPI Number	:	1073518304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TROY D ECKMAN M.D.

Provider Business Mailing Address
First Line	:	809 82ND PKWY
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4607
Country	:	US
Telephone Number	:	309-255-1392
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 E GRANT ST
Second Line	:
City	:	MACOMB
State	:	IL
Zip	:	61455-3352
Country	:	US
Telephone Number	:	309-833-5959
Fax Number	:	309-833-4969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/20/2025

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Directions to “ DR. TROY D ECKMAN M.D.” Practice Location

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