Provider Demographics
NPI:1154328235
Name:ECKHART, TERESA (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ECKHART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6358
Mailing Address - Country:US
Mailing Address - Phone:563-557-5959
Mailing Address - Fax:563-557-5950
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6358
Practice Address - Country:US
Practice Address - Phone:563-557-5959
Practice Address - Fax:563-557-5950
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21918207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31623600Medicaid
IL0180377043Medicaid
IA1182139Medicaid
IL0180377043Medicaid
I3260Medicare PIN