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NPI Code Detail

MEDICARE: ERICH AWENDER MD

MEDICARE: ERICH AWENDER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036-095618IL

General Provider Information

NPI Number : 1295703510
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICH AWENDER MD
Provider Business Mailing Address
First Line : 1045 W STEPHENSON ST
Second Line : PO BOX 857
City : FREEPORT
State : IL
Zip : 61032-4864
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1045 W STEPHENSON ST
Second Line :
City : FREEPORT
State : IL
Zip : 61032-4864
Country : US
Telephone Number : 815-599-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2006
Last Update Date : 11/16/2017

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Directions to “ ERICH AWENDER MD” Practice Location

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