Individual
DR. TINA J ECKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036088865
IL
207W00000X
Ophthalmology Physician
Primary
32758
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060350
IA GROUP MEDICAID
IA
05
—
0188110
—
IA
01
—
09382
IA BCBS
IA
01
—
26568
IA GROUP MEDICARE
IA
01
—
790730
IL GROUP MEDICARE
IL
Enumeration date
02/01/2006
Last updated
03/04/2014
Update your record
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