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Organization
EDUARDO ENCINAS MD SC
Active
Organization
EDUARDO ENCINAS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO JORGE ENCINAS M.D. (PRESIDENT)
(847) 676-3729
Entity
Organization
Contact information
Practice address
4608 S ASHLAND AVE, CHICAGO, IL 60609-3251
(773) 927-7574
Mailing address
6851 LOREL AVE, SKOKIE, IL 60077-3426
(847) 676-3729
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036060976
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619327
BLUE CROSS & BLUE SHIELD
IL
05
—
036060976
—
IL
01
—
31600405
BLUE CROSS & BLUE SHIELD
IL
01
—
742240
MEDICARE ID-TYPE UNSPECIFIED
IL
Enumeration date
11/03/2011
Last updated
11/03/2011
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