Hernaez, Edward E
Hernaez, Edward E is an individual health care provider with primary practice located at 7124 W Touhy Ave , Niles IL 60714-4526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hernaez, Edward E can be contacted via phone (847) 983-8695.Contact Information
Primary practice address
7124 W Touhy Ave
Niles IL 60714-4526
Phone: (847) 983-8695
Fax: (847) 972-1926
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036 093 705 | Illinois |
Profile Details
| NPI number | 1417001108 |
|---|---|
| LBN Legal business name | Hernaez, Edward E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Feb 21st, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417001108 | NPPES |
| Illinois | MEDICAID | 036093705 |
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