Individual
LOWELL Z WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
355 RIDGE AVE, EVANSTON, IL 60202-3328
(847) 316-3364
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041-139585
IL
Other
Enumeration date
05/10/2007
Last updated
06/25/2008
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