Provider Demographics
NPI:1013254853
Name:EWER, ERIKA L (LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:EWER
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 N CALIFORNIA AVE
Mailing Address - Street 2:#6
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-8293
Mailing Address - Country:US
Mailing Address - Phone:323-841-4479
Mailing Address - Fax:
Practice Address - Street 1:914 N CALIFORNIA AVE
Practice Address - Street 2:#6
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-8293
Practice Address - Country:US
Practice Address - Phone:323-841-4479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000879171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist