Individual ProviderEduardo FernandesSurgeryAllopathic & Osteopathic PhysiciansPractice Address1801 W Taylor St, Occ-3f, Chicago, IL 60612(312) 355-1493PECOS EnrollmentBased on the most recent information from CMS, provider Eduardo Fernandes is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1023363934Provider TypeIndividualFull NameFernandes, EduardoTitleDr.CredentialMD, PHDGenderMaleSole ProprietorNoEnumeration Date7/17/2012Last Updated3/14/2019Contact InformationPractice LocationPractice Address1801 W Taylor St, Occ-3f, Chicago, IL 60612Phone(312) 355-1493FaxUnlisted FaxMailing LocationMailing Address840 S Wood St Ste 435e, Chicago, IL 60612-4325Phone(312) 355-1493FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208600000XPrimaryDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicense036.148378IllinoisProvider IdentifiersIDDescriptionIssuerID036.148378DescriptionMedicaidIssuerUnlistedIllinois