Individual
DR. EDWARD TENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4905 OLD ORCHARD CTR, STE 430, SKOKIE, IL 60077-1458
(847) 674-8400
(847) 674-8465
Mailing address
1035 ELMWOOD AVE, WILMETTE, IL 60091-1711
(847) 251-9375
(847) 674-8465
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036053038
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053038
—
IL
Enumeration date
12/23/2005
Last updated
12/14/2011
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