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Organization
MICHIGAN AVENUE INTERNISTS
Active
Organization
MICHIGAN AVENUE INTERNISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG DONALD EWERT M.D. (PRESIDENT)
(312) 922-3815
Entity
Organization
Contact information
Practice address
200 S MICHIGAN AVE, SUITE 805, CHICAGO, IL 60604-2402
(312) 922-3815
(312) 922-3789
Mailing address
200 S MICHIGAN AVE, SUITE 805, CHICAGO, IL 60604-2402
(312) 922-3815
(312) 922-3789
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
IL
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01605414
BC/BS OF ILLINOIS #
IL
Enumeration date
05/03/2006
Last updated
09/11/2025
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