Provider Demographics
NPI:1336148899
Name:SOLANS, ENRIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ENRIC
Middle Name:P
Last Name:SOLANS
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:PO BOX 74821
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60694-4821
Mailing Address - Country:US
Mailing Address - Phone:708-747-5850
Mailing Address - Fax:708-747-9991
Practice Address - Street 1:1 INGALLS DR
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-3558
Practice Address - Country:US
Practice Address - Phone:708-915-5763
Practice Address - Fax:708-915-3686
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083385207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083385Medicaid
IL036083385Medicaid
ILCC3182Medicare PIN
IL379820Medicare PIN
ILL56726Medicare PIN
ILF73718Medicare UPIN
ILL56727Medicare PIN