Healthcare Provider Details

I. General information

NPI: 1417940610
Provider Name (Legal Business Name): ALEXANDER ADAM ESCHBACH PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 GRAND CANYON PKWY SUITE 203
HOFFMAN ESTATES IL
60194-1705
US

IV. Provider business mailing address

800 E. WOODFIELD ROAD SUITE 610
SCHAUMBURG IL
60173
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-0555
  • Fax: 847-755-0580
Mailing address:
  • Phone: 847-240-0444
  • Fax: 847-240-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: