Healthcare Provider Details

I. General information

NPI: 1811341340
Provider Name (Legal Business Name): EUNICE TORRES RIVERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 7-701
CHICAGO IL
60611-2927
US

IV. Provider business mailing address

1000 CENTRAL ST STE 880
EVANSTON IL
60201-1780
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7950
  • Fax: 312-926-4771
Mailing address:
  • Phone: 847-663-8205
  • Fax: 847-663-8211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036158791
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number036158791
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: