Individual
EWA BLACHOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP,APN
Contact information
Practice address
16632 S 107TH CT, ORLAND PARK, IL 60467
(708) 349-6350
(708) 349-9153
Mailing address
16632 S 107TH CT, ORLAND PARK, IL 60467
(708) 349-6350
(708) 349-9153
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006532
STATE LICENSE NUMBER
IL
01
—
P00440573
MEDICARE RAILROAD
—
Enumeration date
04/04/2007
Last updated
01/02/2024
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