Evans, Gary Lewis

Evans, Gary Lewis is an individual health care provider with primary practice located at 311 West Fairchild Street , Danville IL 61832. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Evans, Gary Lewis can be contacted via phone (217) 431-7650.

Contact Information

Primary practice address
311 West Fairchild Street Danville IL 61832
Phone: (217) 431-7650
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X A419 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085003219 Illinois

Profile Details

NPI number 1770507857
LBN Legal business name Evans, Gary Lewis
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Mar 7th, 2023 - about 3 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 1770507857 NPPES
Other 0533210001 DMERC

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