Healthcare Provider Details

I. General information

NPI: 1427475987
Provider Name (Legal Business Name): LAURA EDER HILLARY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2014
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

4946 N DAMEN AVE UNIT 3N
CHICAGO IL
60625-1415
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-3200
  • Fax:
Mailing address:
  • Phone: 847-624-0584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036143089
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: