Provider Demographics
NPI:1477871523
Name:EYMARD SILVA DPM PC
Entity Type:Organization
Organization Name:EYMARD SILVA DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EYMARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-776-3336
Mailing Address - Street 1:5352 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2452
Mailing Address - Country:US
Mailing Address - Phone:708-499-3377
Mailing Address - Fax:708-499-3399
Practice Address - Street 1:5352 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2452
Practice Address - Country:US
Practice Address - Phone:708-499-3377
Practice Address - Fax:708-499-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005020213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4451870001OtherDMERC PTAN# (INDIVIDUAL)
IL4451870001OtherDMERC PTAN# (INDIVIDUAL)