Individual provider · Type 1 NPI

Edwaed Weldon Fowler, PAC

Medical Physician Assistant · Chicago, IL

NPI number 1508987355 Active

Practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

1122 Newberry Ave
La Grange Park, IL 60526-1249

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1508987355

Edwaed Weldon Fowler, PAC's National Provider Identifier is 1508987355, issued on Apr 2, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Chicago, IL. The record was last updated on Jul 8, 2007.