MEDICARE: DR. HOWARD WILLIAM EHRMAN M.D., M.P.H.

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
1	207Q00000X	Family Medicine Physician	36-052260	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	553180	OTHER	IL	MEDICARE GROUP PTAN NUMBER-ROCK CUT LOCATION
2	834340	OTHER	IL	MEDICARE GROUP PTAN NUMBER-SOUTHRIDGE LOCATION

General Provider Information

NPI Number	:	1770540585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD WILLIAM EHRMAN M.D., M.P.H.

Provider Business Mailing Address
First Line	:	2826 S MILLARD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4550
Country	:	US
Telephone Number	:	312-835-3742
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 S MILLARD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4550
Country	:	US
Telephone Number	:	312-835-3742
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/11/2022

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