Provider Demographics
NPI:1497868962
Name:SILVA, EYMARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:EYMARD
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N STATE HIGHWAY 360 APT 421
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3580
Mailing Address - Country:US
Mailing Address - Phone:224-330-4562
Mailing Address - Fax:847-504-5015
Practice Address - Street 1:425 HUEHL RD UNIT 13
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2319
Practice Address - Country:US
Practice Address - Phone:224-330-4562
Practice Address - Fax:847-504-5015
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI856-025213E00000X
IL016005020213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43234300Medicaid
TX343713902Medicaid
TX343713903Medicaid
TX343713904Medicaid
WI480032939OtherRAILROAD MEDICARE
TXP01458549OtherRAILROAD MEDICARE
0732240001OtherDMERC # WITH PPG
IL4451870001OtherDMERC PTAN# (INDIVIDUAL)
TX343713902Medicaid
TX396346YR1KMedicare PIN
WI001086492Medicare PIN
TXP01458549OtherRAILROAD MEDICARE
IL4451870001Medicare NSC
WI864760022Medicare PIN
WI000886550Medicare PIN
WI001086481Medicare PIN
WI000886533Medicare PIN
U85525Medicare UPIN
TX343713903Medicaid
TX396346YPT7Medicare PIN
WI864860022Medicare PIN
ILP00735380Medicare PIN
WI001086499Medicare PIN
WI000585070Medicare PIN
WI000481015Medicare PIN
WI000483045Medicare PIN
IL4451870001OtherDMERC PTAN# (INDIVIDUAL)
WI43234300Medicaid
TX396346ZNDEMedicare PIN