Organization Name: | THE EISENSTEIN CLINIC INC |
NPI Number: | 1114272549 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER SARAH EISENSTEIN (EXECUTIVE DIRECTOR) |
Mailing Address: | 7514 Saint Louis Ave Skokie |
State: | IL US |
Postal Code: | 600764034 |
Phone Number: | 8373292020 |
Fax Number: | 8473292065 |
NPI Enumeration Date: | 07/23/2012 |
NPI Last Update Date: | 07/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |