Provider Demographics
NPI:1417940610
Name:ESCHBACH, ALEXANDER ADAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:ADAM
Last Name:ESCHBACH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E. WOODFIELD ROAD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-240-0444
Mailing Address - Fax:847-240-0446
Practice Address - Street 1:1000 GRAND CANYON PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1705
Practice Address - Country:US
Practice Address - Phone:847-755-0555
Practice Address - Fax:847-755-0580
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1622330OtherBLUE CROSS / BLUE SHIELD
ILR17987Medicare UPIN
IL549100Medicare ID - Type Unspecified