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Contact Information

ANNA M EDMISTON, MD
300 N MILWAUKEE AVE STE L
LAKE VILLA, IL60046
 Phone: 847-356-0700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for ANNA M EDMISTON · (Female)

NPI Number 1386055762
Status Active
Credentials MD
Entity Individual
Enumeration date 05/19/2014
Last updated 07/25/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.146283
  • IL Other 036.146283 ILLINOIS LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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