Ews Internal Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036094253 Issued in IL

Legal business name

EWS INTERNAL MEDICINE, LLC

Practice address

2500 Ridge Ave
Suite 104
Evanston, IL 60201-2455

Phone

(847) 869-1192

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Samira Mendoza

Title

Credentialing Manager

Phone

(630) 628-9600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth King Woo-Strauss, M.D.

  • Internal Medicine Physician
  • Evanston, IL
  • NPI 1154392645
  Medicare reassignment NPD
• Jeffrey George Geohas, M.D.

  • Internal Medicine Physician
  • Evanston, IL
  • NPI 1609846351
  NPD

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1790043933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIDGE AVE",
            "address_2": "SUITE 104",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012455",
            "telephone_number": "847-869-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 RIDGE AVE",
            "address_2": "SUITE 104",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012455",
            "telephone_number": "847-869-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EWS INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "SAMIRA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-628-9600"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Everson, CRNA
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• Mei-Ling Ewbank, MD
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• Catherine Anne Fabian, AU.D.
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• Daniel Patrick Fagin, M.D.
• Mohammed Shahrukh Fahad, MD

• Internal Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.