Individual
EIMAN EL TAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(479) 826-7158
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(479) 826-7158
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036125755
IL
207VX0000X
Obstetrics Physician
4301083889
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036125755
MEDICAL LICENSE
IL
Enumeration date
05/21/2007
Last updated
08/04/2023
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