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EDGAR E ARCHBOLD M.D NPI 1801003991


NPI Information

NPI: 1801003991
Provider Name: EDGAR E ARCHBOLD, M.D
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
6917 W CERMAK RD
BERWYN, IL
ZIP 60408
Phone: (708) 749-8190
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Edgar E Archbold, M.D is a family medicine in Berwyn, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Edgar E Archbold, M.D NPI is 1801003991. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6917 W CERMAK RD
BERWYN, IL
ZIP 60408
Phone: (708) 749-8190
Fax: (708) 749-8190

The enumeration date for this NPI number is 5/17/2007 and was last updated on 12/22/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036069407ILLINOISNo
2207Q00000XFamily Medicine036-069407ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1727980MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2036068407MEDICAIDILLINOIS
301625394OTHERILLINOISBS
4C46088MEDICARE UPIN
5216410MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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