Provider Demographics
NPI:1629089958
Name:ECHOLS, HARVEY LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:LAWRENCE
Last Name:ECHOLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 OLD ORCHARD RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4407
Mailing Address - Country:US
Mailing Address - Phone:847-470-1915
Mailing Address - Fax:847-470-1916
Practice Address - Street 1:5202 OLD ORCHARD RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4407
Practice Address - Country:US
Practice Address - Phone:847-470-1915
Practice Address - Fax:847-470-1916
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078648174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336041707OtherSTATE CONTROLLED SUBSTANC
IL036078648OtherLICENSE
IL036078648OtherLICENSE
IL036078648OtherLICENSE