Trachtenberg, Jeffrey David

Trachtenberg, Jeffrey David is an individual health care provider with primary practice located at 1800 E Lake Shore Dr , Decatur IL 62521-3810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Trachtenberg, Jeffrey David can be contacted via phone (217) 464-1722.

Contact Information

Primary practice address
1800 E Lake Shore Dr Decatur IL 62521-3810
Phone: (217) 464-1722
Fax: (217) 464-1717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036103845 Illinois

Profile Details

NPI number 1821070517
LBN Legal business name Trachtenberg, Jeffrey David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Dec 21st, 2021 - about 3 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 1821070517 NPPES
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