Individual
JACOB SETH ECANOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE., DEPARTMENT OF RADIOLOGY, EVANSTON, IL 60201-1718
(847) 570-2475
(847) 570-2942
Mailing address
2650 RIDGE AVE., DEPARTMENT OF RADIOLOGY, EVANSTON, IL 60201-1718
(847) 570-2475
(847) 570-2942
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036095636
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095636
—
IL
Enumeration date
06/08/2006
Last updated
12/04/2018
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