Provider Demographics
NPI:1679947790
Name:EGGERS, JAMES D (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:EGGERS
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 1:2020 CHESTNUT AVE
Mailing Address - Street 2:APT 404
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1651
Mailing Address - Country:US
Mailing Address - Phone:847-724-8956
Mailing Address - Fax:847-724-8956
Practice Address - Street 1:2020 CHESTNUT AVE
Practice Address - Street 2:APT 404
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1651
Practice Address - Country:US
Practice Address - Phone:847-724-8956
Practice Address - Fax:847-724-8956
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036041853207V00000X
SCVL85207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology