Healthcare Provider Details

I. General information

NPI: 1194766352
Provider Name (Legal Business Name): EDWARD M. ATKINS, M.D.,S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HOWARD ST
EVANSTON IL
60202-3916
US

IV. Provider business mailing address

8135 N MILWAUKEE AVE
NILES IL
60714-2828
US

V. Phone/Fax

Practice location:
  • Phone: 847-869-8500
  • Fax:
Mailing address:
  • Phone: 847-967-1149
  • Fax: 847-967-8594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. EDWARD M. ATKINS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-967-1149