Healthcare Provider Details

I. General information

NPI: 1720630700
Provider Name (Legal Business Name): AARON ESCOVITZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 DOTY RD
WOODSTOCK IL
60098-7509
US

IV. Provider business mailing address

3701 DOTY RD
WOODSTOCK IL
60098-7509
US

V. Phone/Fax

Practice location:
  • Phone: 815-334-5018
  • Fax: 815-334-3185
Mailing address:
  • Phone: 815-334-5018
  • Fax: 815-334-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number281019
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036162949
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: