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NPI Code Detail

MEDICARE: DR. EDWARD L SINGLETON M.D.

MEDICARE: DR. EDWARD L SINGLETON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician036-064587IL
22085R0202XDiagnostic Radiology Physician036.064587IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700855806
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD L SINGLETON M.D.
Provider Business Mailing Address
First Line : 1900 SILVER CROSS BLVD
Second Line :
City : NEW LENOX
State : IL
Zip : 60451-9509
Country : US
Telephone Number : 815-300-7303
Fax Number : 815-723-9823
Provider Business Practice Location Address
First Line : 1900 SILVER CROSS BLVD
Second Line :
City : NEW LENOX
State : IL
Zip : 60451-9509
Country : US
Telephone Number : 815-300-7303
Fax Number : 815-723-9823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 05/01/2019

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