Edward Tenner, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036053038 Issued in IL

Practice address

4905 Old Orchard Ctr
Ste 430
Skokie, IL 60077-1458

Phone

(847) 674-8400

Fax

(847) 674-8465

NPI assigned

Dec 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Suburban Eye Associates, LTD.

  • Ophthalmology Physician
  • Deerfield, IL
  • NPI 1275721169
  NPD (past)

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1508843285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 ELMWOOD AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911711",
            "telephone_number": "847-251-9375",
            "fax_number": "847-674-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "STE 430",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771458",
            "telephone_number": "847-674-8400",
            "fax_number": "847-674-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNER",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036053038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053038",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Kenerson Tebbens, LPC, NCC
• Teddy Rose Inc.
• Christina Tejeda
• David Wayne Temple, LCSW
• Tender Touch Home Health Care, Inc.
• Nicole Alexandra Tepinski, PA-C
• Nikol Ternoir
• TFB Ecom Fintech LLC
• The a.R.C. of Jacksonville, LTD
• The Art of a Smile Dental Studio, PC

• Ophthalmology Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.