Organization
EWS INTERNAL MEDICINE, LLC
Active
Organization
EWS INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIRA MENDOZA (CREDENTIALING MANAGER)
(630) 628-9600
Entity
Organization
Contact information
Practice address
2500 RIDGE AVE, SUITE 104, EVANSTON, IL 60201-2455
(847) 869-1192
Mailing address
2500 RIDGE AVE, SUITE 104, EVANSTON, IL 60201-2455
(847) 869-1192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036094253
IL
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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