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General NPI Number Information
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NPI Number | 1740540178
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Entity Type | Organization
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Legal Business Name | MICHAEL A. EPSTEIN MD SC
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 1535 LAKE COOK RD SUITE 211
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City | NORTHBROOK
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State | IL
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Zip | 60062-1447
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Country | US
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Telephone | 847-205-1680
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 LAKE COOK RD SUITE 211
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City | NORTHBROOK
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State | IL
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Zip | 60062-1447
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Country | US
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Telephone | 847-205-1680
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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. MICHAEL A EPSTEIN
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Credential | MD
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Telephone | 847-205-1680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036-074140
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License Number State | IL
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