Provider Demographics
NPI:1770540585
Name:EHRMAN, HOWARD WILLIAM (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:WILLIAM
Last Name:EHRMAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:
Other - Last Name:EHRMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD MPH
Mailing Address - Street 1:2826 S MILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-4550
Mailing Address - Country:US
Mailing Address - Phone:312-835-3742
Mailing Address - Fax:
Practice Address - Street 1:2826 S MILLARD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4550
Practice Address - Country:US
Practice Address - Phone:312-835-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-052260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL553180OtherMEDICARE GROUP PTAN NUMBER-ROCK CUT LOCATION
IL834340OtherMEDICARE GROUP PTAN NUMBER-SOUTHRIDGE LOCATION
ILC46594Medicare UPIN
IL834340OtherMEDICARE GROUP PTAN NUMBER-SOUTHRIDGE LOCATION
IL553180026Medicare PIN