Ecanow, Jacob Seth

Ecanow, Jacob Seth is an individual health care provider with primary practice located at 2650 Ridge Ave. Department Of Radiology, Evanston IL 60201-1718. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ecanow, Jacob Seth can be contacted via phone (847) 570-2475.

Contact Information

Primary practice address
2650 Ridge Ave. Department Of Radiology Evanston IL 60201-1718
Phone: (847) 570-2475
Fax: (847) 570-2942
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036095636 Illinois

Profile Details

NPI number 1104866805
LBN Legal business name Ecanow, Jacob Seth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Dec 4th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104866805 NPPES
Illinois MEDICAID 036095636

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