Eziaha R Georgewill
Nurse Practitioner - Primary Care
17800 Kedzie Ave # A
Hazel Crest
, Illinois 60429-2029
Eziaha R Georgewill
Nurse Practitioner - Primary Care
17800 Kedzie Ave # A
Hazel Crest
, Illinois 60429-2029
(708) 799-8000
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Eziaha R Georgewill
- 17800 Kedzie Ave
- Hazel Crest, IL
- Zip : 60429-2029
- Phone : (708) 799-8000
Second Address
- Eziaha R Georgewill
- 17800 Kedzie Ave # A
- Hazel Crest, IL
- Zip : 60429-2029
- Phone : (708) 799-8000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | 209.021912 | IL |
National Provider Identifier
| NPI | 1013521038 |
|---|---|
| Provider Name | Eziaha R Georgewill |
| First Address | Hazel Crest, IL 60429-2029 |
| Second Address | Hazel Crest, IL 60429-2029 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/09/2020 |
| Last Update Date | 08/09/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.