Provider Demographics
NPI:1063543346
Name:WINTER, EDWARD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20945 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1832
Mailing Address - Country:US
Mailing Address - Phone:708-747-6929
Mailing Address - Fax:708-747-6929
Practice Address - Street 1:20945 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1832
Practice Address - Country:US
Practice Address - Phone:708-747-6929
Practice Address - Fax:708-747-6929
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine