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Dr. Ethan Lewis Segal, MD
Student in an Organized Health Care Education/Training Program in Maywood, Illinois
NPI 1932427036

Ethan Lewis Segal is a Student in an Organized Health Care Education/Training Program based in Forest Park, IL. Ethan Lewis Segal practices in Maywood, IL and has the professional credentials of MD. The NPI Number for Ethan Lewis Segal is 1932427036 and holds a License No. (Illinois).

The current practice location address for Ethan Lewis Segal is 2160 S 1St Ave, Maywood, IL and can be reached out via phone at 708-216-8066.

Location: 2160 S 1St Ave, Maywood, IL, 60130-3011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932427036
Provider Name
Ethan Lewis Segal
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2160 S 1St Ave, Maywood, IL, 60130-3011
Phone Number
708-216-8066
Fax Number
Provider Enumeration Date
05/13/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
708-216-8066
Fax Number
person
Provider Business Mailing Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
708-216-8066
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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