Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | IL | |
N | 111NI0900X | Internist | IL | |
N | 207RA0401X | Internist - Addiction Medicine | IL |
NPI | 1063543346 |
---|---|
Provider Name | Dr. Edward Joseph Winter |
First Address | Olympia Fields, IL 60461-1832 |
Second Address | Olympia Fields, IL 60461-1832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |