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General NPI Number Information
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NPI Number | 1326385972
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Entity Type | Organization
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Legal Business Name | EISENSTEIN MEDICAL CENTERS
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 1100 SHERMAN AVE STE 107
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City | NAPERVILLE
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State | IL
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Zip | 60563-4855
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Country | US
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Telephone | 773-895-3311
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Fax | 866-272-8433
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Provider Business Mailing Address
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Address Line | 2757 W JARLATH ST
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City | CHICAGO
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State | IL
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Zip | 60645-1317
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Country | US
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Telephone | 773-895-3311
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Fax | 866-272-8433
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAYER EISENSTEIN
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Credential | M.D.
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Telephone | 773-895-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-048275
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License Number State | IL
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