Healthcare Provider Details

I. General information

NPI: 1932240405
Provider Name (Legal Business Name): EVA M CHWASTOWSKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1222
US

IV. Provider business mailing address

25 N WINFIELD RD FL 3
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-2113
  • Fax: 630-933-4520
Mailing address:
  • Phone: 630-933-2113
  • Fax: 630-933-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110584
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085002907
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: