Stevens, Dominique Maya
Stevens, Dominique Maya is an individual health care provider with primary practice located at 633 Emerson St , Evanston IL 60208-0844. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Stevens, Dominique Maya can be contacted via phone (847) 491-5470.Contact Information
Primary practice address
633 Emerson St
Evanston IL 60208-0844
Phone: (847) 491-5470
Fax: (847) 491-5919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 036154015 | Illinois |
Profile Details
| NPI number | 1346604725 |
|---|---|
| LBN Legal business name | Stevens, Dominique Maya |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2016 |
| Last updated | Dec 7th, 2021 - about 5 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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