Provider Demographics
NPI:1841617057
Name:TROTTER, ASHLEY E (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:TROTTER
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 1:777 PARK AVE. WEST
Mailing Address - Street 2:IM HOSPITALISTS
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2433
Mailing Address - Country:US
Mailing Address - Phone:847-926-5840
Mailing Address - Fax:847-926-5835
Practice Address - Street 1:777 PARK AVE. WEST
Practice Address - Street 2:IM HOSPITALISTS
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-926-5840
Practice Address - Fax:847-926-5835
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036147893207R00000X, 208M00000X
OH35130392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124078Medicaid