Individual ProviderAndrew EwbankObstetrics & GynecologyAllopathic & Osteopathic PhysiciansPractice Address1701 W Superior St, Chicago, IL 60622(312) 666-3494PECOS EnrollmentBased on the most recent information from CMS, provider Andrew Ewbank is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1073904256Provider TypeIndividualFull NameEwbank, AndrewCredentialMDGenderMaleSole ProprietorNoEnumeration Date2/10/2015Last Updated8/9/2021Contact InformationPractice LocationPractice Address1701 W Superior St, Chicago, IL 60622Phone(312) 666-3494FaxUnlisted FaxMailing LocationMailing Address1285 Hartrey Ave, Evanston, IL 60202-1056Phone(312) 666-3494FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207V00000XPrimaryDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense036150639IllinoisCode207V00000XDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense036.150639Illinois