Provider Demographics
NPI:1225005820
Name:OSTROWSKI, EVA T (MD)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:T
Last Name:OSTROWSKI
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 1:800 FOX GLN
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6461
Mailing Address - Country:US
Mailing Address - Phone:847-382-5850
Mailing Address - Fax:847-382-5852
Practice Address - Street 1:800 FOX GLN
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6461
Practice Address - Country:US
Practice Address - Phone:847-382-5850
Practice Address - Fax:847-382-5852
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211615Medicare ID - Type Unspecified
ILE64531Medicare UPIN