Provider Demographics
NPI:1114158821
Name:DEMBOWSKI, EWA (MD)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:DEMBOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 W RAND RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1157
Mailing Address - Country:US
Mailing Address - Phone:847-618-0326
Mailing Address - Fax:708-618-5459
Practice Address - Street 1:199 W RAND RD STE 203
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1157
Practice Address - Country:US
Practice Address - Phone:847-618-0326
Practice Address - Fax:708-618-5459
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113912207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036113912Medicaid
IL1720371669OtherNPI GROUP PRACTICE
ILIL6304022Medicare PIN