EZIAHA R GEORGEWILL (NPI# 1013521038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013521038 |
| Entity Type | Individual |
| Full Name | EZIAHA R GEORGEWILL |
| Credential | APRN-BC, C |
| Practice Address |
17800 Kedzie Ave # A Hazel Crest IL 60429-2029 |
| Mailing Address |
17800 Kedzie Ave Hazel Crest IL 60429-2029 |
| Practice Telephone | 7087998000 |
| Mailing Telephone | 7087998000 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
209.021912 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
17800 KEDZIE AVE # A |
| City | HAZEL CREST |
| State | IL |
| Zip Code | 60429-2029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917987 | Nancy Sinwelski | Technician | 17305 Fisk Street, East Hazelcrest, IL 60429 | 2019-11-21 |
| 1144720871 | Plentiful Hair Studio LLC | Specialist | 17504 E Carriageway Dr Ste D, Hazel Crest, IL 60429 | 2018-02-19 |
| 1376052142 | Natalie Allen | Counselor | 3518 Birchwood Dr, Hazel Crest, IL 60429 | 2017-09-25 |
| 1730534009 | Lydena Franklin | Counselor | 1909 Cheker Square, East Hazel Crest, IL 60429 | 2016-04-25 |
| 1710331053 | Lauiren Orta | Counselor | 1901 Cheker Square, E Hazel Crest, IL 60429 | 2016-04-22 |
| 1427423367 | Andrea Leigh Warren | Nurse Practitioner | 17800 S. Kedzie Ave, Hazel Crest, IL 60429 | 2015-12-03 |
| 1770969354 | Karriem's Developmental Services | Day Training, Developmentally Disabled Services | 18513 River Road, Hazel Crest, IL 60429 | 2015-08-05 |
| 1073905170 | James Kamper | Physical Therapy Assistant | 1816 W 170th Street, Hazel Crest, IL 60429 | 2015-02-26 |
| 1194066019 | Marilyn C Scott | Psychologist | 18505 Meadow Ln., Hazel Crest, IL 60429 | 2013-03-04 |
| 1649548405 | Supported Independence | Community/Behavioral Health | 17009 Elm Drive, Hazel Crest, IL 60429 | 2011-12-08 |
| Find all providers in zip 60429 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225636475 | Monika Sitko | Nurse Practitioner | 3 E 14th Pl, Lombard, IL 60148-4574 | 2020-10-10 |
| 1134735343 | Michael Fitz | Nurse Practitioner | 6205 Westminster Ct, Springfield, IL 62711-6728 | 2020-09-22 |
| 1447870274 | 15 Park Place LLC | Nurse Practitioner | 15 Park Pl Ste 1, Swansea, IL 62226-2918 | 2020-04-22 |
| 1861021248 | Elizabeth Horan | Nurse Practitioner | 125 S Green St Apt 1005a, Chicago, IL 60607-3717 | 2020-04-07 |
| 1699315697 | Kelsey L Proehl | Nurse Practitioner | 70 Meadowview Ctr Ste 300, Kankakee, IL 60901-2062 | 2020-01-08 |
| 1992343248 | Maryanne M Smith | Nurse Practitioner | 805 W Deyoung St Ste D, Marion, IL 62959-1602 | 2019-12-17 |
| 1730724451 | Suzana None Nikitovic | Nurse Practitioner | 2815 Regner Rd, Mchenry, IL 60051-6942 | 2019-11-18 |
| 1104461870 | Swanson Family Practice LLC | Nurse Practitioner | 733 N Logan Ave Ste 1, Danville, IL 61832-4378 | 2019-11-16 |
| 1205471083 | Sylvia Coleman | Nurse Practitioner | 20 W Kinzie St Ste 17, Chicago, IL 60654-6393 | 2019-11-15 |
| 1194374637 | Elena Ignatiev | Nurse Practitioner | 1626 W Farwell Ave Apt 3g, Chicago, IL 60626-3641 | 2019-09-07 |
| Find all providers with the same taxonomy | ||||
| City | HAZEL CREST |
| Zip Code | 60429 |
Please comment or provide details below to improve the information on EZIAHA R GEORGEWILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.