Individual
EZIAHA R GEORGEWILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC, C
Contact information
Practice address
17800 KEDZIE AVE # A, HAZEL CREST, IL 60429-2029
(708) 799-8000
Mailing address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 799-8000
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209.021912
IL
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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