Provider Demographics
NPI:1891063988
Name:KINSER, EWA MARIA (ANP)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:MARIA
Last Name:KINSER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WINTHROP AVE
Mailing Address - Street 2:AMBULATORY CARE
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1405
Mailing Address - Country:US
Mailing Address - Phone:630-545-4935
Mailing Address - Fax:630-592-2239
Practice Address - Street 1:701 WINTHROP AVE
Practice Address - Street 2:AMBULATORY CARE
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1405
Practice Address - Country:US
Practice Address - Phone:630-545-4935
Practice Address - Fax:630-592-2239
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008965363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health