Provider Demographics
NPI:1114272549
Name:THE EISENSTEIN CLINIC INC
Entity Type:Organization
Organization Name:THE EISENSTEIN CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:EISENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:847-329-2020
Mailing Address - Street 1:7514 SAINT LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-4034
Mailing Address - Country:US
Mailing Address - Phone:837-329-2020
Mailing Address - Fax:847-329-2065
Practice Address - Street 1:7514 SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-4034
Practice Address - Country:US
Practice Address - Phone:837-329-2020
Practice Address - Fax:847-329-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty