Individual provider · NPI-1
Zachary B. Bulwa, MD, MS
Psychiatry & Neurology, Neurology · Evanston, IL
NPI number1164876553
StatusActive
Last updated in NPPESSep 13, 2021
Details
- NPI
- 1164876553
- Entity type
- Individual (NPI-1)
- Name
- Zachary B. Bulwa
- Credential
- MD, MS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2016
- Certification date
- Sep 13, 2021
- Last updated
- Sep 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | 036152509 | IL | Yes |
Practice location
1000 Central St Ste 880Evanston, IL 60201-1780
Phone 847-570-2570 · Fax 847-570-2073
Mailing address
1000 Central St Ste 880Evanston, IL 60201-1780
Phone 847-570-2570 · Fax 847-570-2073
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