Evanston Regional Physicians LLC
Emergency Medicine in Evanston, WY. Organization (NPI-2).
NPI number1073167359
StatusActive
Last updated in NPPESOct 9, 2019
Details
- NPI
- 1073167359
- Entity type
- Organization (NPI-2)
- Legal business name
- Evanston Regional Physicians LLC
- Organization subpart
- No
- Enumeration date
- Jul 25, 2019
- Last updated
- Oct 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – |
Practice location
190 Arrowhead DrEvanston, WY 82930-9266
Phone 307-789-3636
Mailing address
Po Box 734597Chicago, IL 60673-4597
Authorized official
Robert H. Parker
Ceo
8014637415
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