NPIMap

Individual provider Active NPI

Ewa Poltorak, MD

  • Anesthesiology Physician
  • Glenview, IL
National Provider Identifier
1558307603
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01058615 Issued in IN
Practice address
503 Elm Street
Glenview, IL 60025-4158
Phone
(847) 687-6759
Fax
(847) 730-3729
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01058615 IN Primary

Addresses

Primary practice location

503 Elm Street
Glenview, IL 60025-4158

Mailing address

503 Elm Street
Glenview, IL 60025-4158
Phone (847) 687-6759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
GLHS Anesthesia Group Anesthesiology Past Accepting new patients
Monroe Physicians Group Past Accepting new patients
Anesthesia Care of Bloomington PC Anesthesiology Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558307603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 ELM STREET",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254158",
            "telephone_number": "847-687-6759",
            "fax_number": "847-730-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 ELM STREET",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254158",
            "telephone_number": "847-687-6759",
            "fax_number": "847-730-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLTORAK",
        "first_name": "EWA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01058615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.