Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 036115775 | IL |
N | 207V00000X | Obstetrician & Gynecologist | 036-115775 | IL |
NPI | 1114113271 |
---|---|
Provider Name | Ewa Nowak |
First Address | Chicago, IL 60618-5811 |
Second Address | Chicago, IL 60618-5811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2007 |
Last Update Date | 22/05/2013 |