Provider Demographics
NPI:1972556264
Name:EINHORN, HOWARD LYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LYLE
Last Name:EINHORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:675 W NORTH AVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1634
Mailing Address - Country:US
Mailing Address - Phone:708-450-5745
Mailing Address - Fax:708-345-3927
Practice Address - Street 1:675 W NORTH AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1634
Practice Address - Country:US
Practice Address - Phone:708-450-5745
Practice Address - Fax:708-345-3927
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056302207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01608583OtherBLUE CROSS BLUE SHIELD
IL01608583OtherBLUE CROSS BLUE SHIELD
ILC44067Medicare UPIN