Individual
MR. OWAIZ ANSARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE STE 1304, EVANSTON, IL 60201-1700
(847) 570-2000
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2475
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036160950
IL
2085R0202X
Diagnostic Radiology Physician
Primary
125.073828
IL
Other
Enumeration date
12/07/2015
Last updated
07/01/2024
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