Healthcare Provider Details
I. General information
NPI: 1083951131
Provider Name (Legal Business Name): EYMARD SILVA DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2013
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5600 W ADDISON ST SUITE 206
CHICAGO IL
60634-4401
US
IV. Provider business mailing address
5600 W ADDISON ST SUITE 206
CHICAGO IL
60634-4401
US
V. Phone/Fax
- Phone: 773-481-6647
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EYMARD
SILVA
Title or Position: PRESIDENT
Credential:
Phone: 773-481-6647