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General NPI Number Information
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NPI Number | 1245516376
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Entity Type | Organization
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Legal Business Name | EDUARDO ENCINAS MD SC
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 4608 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60609-3251
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Country | US
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Telephone | 773-927-7574
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Fax |
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Provider Business Mailing Address
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Address Line | 6851 LOREL AVE
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City | SKOKIE
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State | IL
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Zip | 60077-3426
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Country | US
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Telephone | 847-676-3729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDUARDO JORGE ENCINAS
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Credential | M.D.
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Telephone | 847-676-3729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036060976
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License Number State | IL
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