WILLIAM B EVANS MD SC NPI 1962492785

NPI Information

NPI: 1962492785
Provider Name: WILLIAM B EVANS MD SC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
4647 LINCOLN HWY
MATTESON, IL
ZIP 60443
Phone: (708) 481-4200
Get Directions

WILLIAM B EVANS MD SC is a nephrology internal medicine in Matteson, IL. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. WILLIAM B EVANS MD SC NPI is 1962492785. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4647 LINCOLN HWY
MATTESON, IL
ZIP 60443-319
Phone: (708) 481-4200
Fax: (708) 481-3302

The provider's authorized official is William B Evans .
The authorized official title is President and has the following contact phone number (708) 481-4200.

The enumeration date for this NPI number is 10/24/2005 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No
2	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01622854	OTHER		BCBSIL GROUP NUMBER
2	201977	MEDICARE PIN	ILLINOIS
3	146200	MEDICARE PIN	ILLINOIS
4	209094	MEDICARE PIN	ILLINOIS
5	=========	OTHER		EIN
6	D14654	MEDICARE UPIN	ILLINOIS
7	CH6644	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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