Healthcare Provider Details

I. General information

NPI: 1285632091
Provider Name (Legal Business Name): EDWARD M ATKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date: 03/17/2006
Reactivation Date: 03/24/2006

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: 847-869-0028
Mailing address:
  • Phone: 847-967-8098
  • 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:
Title or Position:
Credential:
Phone: