Individual provider · NPI-1

Dr. Evora Juanita Brent, MD

Pediatrics, Developmental - Behavioral Pediatrics · Evanston, IL

NPI number1326335514
StatusActive
Last updated in NPPESMar 24, 2021

Details

NPI
1326335514
Entity type
Individual (NPI-1)
Name
Dr. Evora Juanita Brent
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jul 7, 2011
Certification date
Mar 24, 2021
Last updated
Mar 24, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0006X Pediatrics, Developmental - Behavioral Pediatrics036138274ILYes

Other names

  • Evora Juanita Newby (Former Name)

Practice location

1000 Central St.
Suite 800
Evanston, IL 60201-1780

Phone 847-570-2577 · Fax 847-733-5424

Mailing address

2650 Ridge Ave Room 1223
Evanston, IL 60201-1718

Phone 847-570-2040 · Fax 847-733-5315

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