Provider Demographics
NPI:1609846815
Name:EISENSTEIN, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:EISENSTEIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:900 N WESTMORELAND RD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1674
Mailing Address - Country:US
Mailing Address - Phone:847-482-0273
Mailing Address - Fax:847-615-1708
Practice Address - Street 1:767 PARK AVE W
Practice Address - Street 2:SUITE 230
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2400
Practice Address - Country:US
Practice Address - Phone:847-681-7100
Practice Address - Fax:847-681-7110
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-01-07
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Provider Licenses
StateLicense IDTaxonomies
IL036087505208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4919303OtherBCBS