Provider Demographics
NPI:1790711729
Name:ESKANDARI, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ESKANDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-695-2714
Mailing Address - Fax:312-695-2461
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:GALTER 19-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-2714
Practice Address - Fax:312-695-2461
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360998402086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036099840Medicaid
IL036099840Medicaid
IL709490Medicare PIN