Organization
MYRON BORNSTEIN MD SC
Active
Other names
MYRON BORNSTEIN MD SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRON BORNSTEIN M.D. (PRESIDENT)
(847) 433-7001
Entity
Organization
Contact information
Practice address
425 DAVIS ST UNIT 519, EVANSTON, IL 60201-4790
(847) 433-2290
Mailing address
1770 1ST ST, HIGHLAND PARK, IL 60035-3200
(847) 433-2290
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-038938
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208695
MEDICARE SC ID
IL
Enumeration date
01/02/2008
Last updated
10/30/2020
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