Individual
DEEPAK P EDWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1855 W TAYLOR ST, CHICAGO, IL 60612-7242
(312) 996-7030
Mailing address
1855 W TAYLOR ST, CHICAGO, IL 60612-7242
(312) 996-6590
(312) 996-7770
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036088088
IL
207W00000X
Ophthalmology Physician
35090220
OH
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
036088088
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2770925
—
OH
Enumeration date
08/09/2006
Last updated
04/14/2025
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