Healthcare Provider Details

I. General information

NPI: 1114737376
Provider Name (Legal Business Name): ALEXANDER WINTERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 RIDGE AVE
EVANSTON IL
60202-3399
US

IV. Provider business mailing address

355 RIDGE AVE
EVANSTON IL
60202-3328
US

V. Phone/Fax

Practice location:
  • Phone: 847-316-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125.088412
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: