Individual
DR. EWA V HAMPSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12130 S HARLEM AVE, SUITE B, PALOS HEIGHTS, IL 60463-1458
(708) 448-5500
(708) 448-5501
Mailing address
12130 S HARLEM AVE, SUITE B, PALOS HEIGHTS, IL 60463-1458
(708) 448-5500
(708) 448-5501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-111262
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00215605
RAILROAD MEDICARE
IL
Enumeration date
08/31/2006
Last updated
09/23/2009
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