Provider Demographics
NPI:1083789127
Name:WINSLOW, EDWARD BJ (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:BJ
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:9977 WOODS DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1057
Practice Address - Country:US
Practice Address - Phone:847-663-8410
Practice Address - Fax:847-663-8411
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC41785Medicare UPIN