Evans, Lisa
Evans, Lisa is an individual health care provider with primary practice located at 2300 N Rockton Ave , Rockford IL 61103-3619. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Evans, Lisa can be contacted via phone (815) 971-2000.Contact Information
Primary practice address
2300 N Rockton Ave
Rockford IL 61103-3619
Phone: (815) 971-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 364SP0200X | 209006345 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 209006345 | Illinois |
Profile Details
| NPI number | 1750539078 |
|---|---|
| LBN Legal business name | Evans, Lisa |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2008 |
| Last updated | May 28th, 2024 - about 2 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 | 1750539078 | NPPES |
| Illinois | Other | 209006345 | LICENSE |
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