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Evanston Northwestern Healthcare is pleased to provide a primary source verification service of our Professional Staff membership. The search results will be printed as a credentialing verification letter.

If you have any questions or require assistance please contact the Professional Staff Office at 847.570.1644.

Your Information

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This information is only used when creating your verification letter. None of your information will be stored.

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Physician's Last Name

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Professional Staff Office Evanston Hospital 2650 Ridge Avenue Evanston, IL 60201 (847) 570-2040 (847) 570-1248 fax

Re: Professional Staff Membership or Affiliation
      Primary Source Verification
      Evanston Hospital, Glenbrook Hospital and Highland Park Hospital

In response to your request for information regarding the following practitioner, our records indicate the following:

Name of Physician	Date on Staff	Department	Status

For any other information, a written request with an appropriate authorization release must be submitted. If there are any questions, please call 847.570.1644.

Sincerely,

Professional Staff Office
Evanston Northwestern Healthcare