Provider Demographics
NPI:1851397350
Name:EISENSTEIN, BYRON I (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:I
Last Name:EISENSTEIN
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 1:880 W CENTRAL RD
Mailing Address - Street 2:STE 7200
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2382
Mailing Address - Country:US
Mailing Address - Phone:847-259-2530
Mailing Address - Fax:847-259-2536
Practice Address - Street 1:880 W CENTRAL RD
Practice Address - Street 2:STE 7200
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2382
Practice Address - Country:US
Practice Address - Phone:847-259-2530
Practice Address - Fax:847-259-2536
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC40352Medicare UPIN
ILP04711Medicare ID - Type Unspecified