Provider Demographics
NPI:1801892682
Name:TORRES, HERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:HERNANDO
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2089 OLD WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2936
Mailing Address - Country:US
Mailing Address - Phone:847-441-5157
Mailing Address - Fax:847-441-5158
Practice Address - Street 1:2720 W 15TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1610
Practice Address - Country:US
Practice Address - Phone:773-257-6702
Practice Address - Fax:773-257-6116
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL264-01-56-01-4OtherAMA #
IL264-01-56-01-4OtherAMA #
IL474230Medicare ID - Type UnspecifiedPROVIDER