NPIMap

Organization Active NPI

Eduardo Encinas MD SC

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1245516376
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036060976 Issued in IL
Legal business name
EDUARDO ENCINAS MD SC
Practice address
4608 S Ashland Ave
Chicago, IL 60609-3251
Phone
(773) 927-7574
NPI assigned
Nov 3, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eduardo Jorge Encinas, M.D.NPI 1457430910
Title
President
Phone
(847) 676-3729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036060976 IL Primary

Addresses

Primary practice location

4608 S Ashland Ave
Chicago, IL 60609-3251

Mailing address

6851 Lorel Ave
Skokie, IL 60077-3426
Phone (847) 676-3729

Other identifiers 4

IdentifierTypeStateIssuer
01619327OtherILBLUE CROSS & BLUE SHIELD
31600405OtherILBLUE CROSS & BLUE SHIELD
742240OtherILMEDICARE ID-TYPE UNSPECIFIED
036060976MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1245516376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 LOREL AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773426",
            "telephone_number": "847-676-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093251",
            "telephone_number": "773-927-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO ENCINAS MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "ENCINAS",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "JORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-676-3729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036060976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "01619327",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "31600405",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "742240",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036060976",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.