Evans, Carlotta Ann

Evans, Carlotta Ann is an individual health care provider with primary practice located at 801 S Paulina St Mc 841, Chicago IL 60612-7210. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Evans, Carlotta Ann can be contacted via phone (312) 996-7138.

Contact Information

Primary practice address
801 S Paulina St Mc 841 Chicago IL 60612-7210
Phone: (312) 996-7138
Fax: (312) 996-0873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 021-001786 Illinois

Profile Details

NPI number 1124018841
LBN Legal business name Evans, Carlotta Ann
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Sep 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124018841 NPPES
Illinois MEDICAID A2741KD1

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