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Individual
MICHELLE LEE VAN EWYK
Active
Individual
MICHELLE LEE VAN EWYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.412825
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209.018061
IL
363LP0200X
Pediatric Nurse Practitioner
277.002143
IL
Other
Enumeration date
09/15/2018
Last updated
04/27/2026
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