Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 70011662 | IL |
N | 2251G0304X | Physical Therapist - Geriatrics | 70011662 | IL |
NPI | 1134225584 |
---|---|
Provider Name | Mr. Leonard Bernard Eisner |
First Address | Buffalo Grove, IL 60089 |
Second Address | Glenview, IL 60026-5805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |