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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124018841 | NPPES |
| Illinois | MEDICAID | A2741KD1 |
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