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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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