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Organization
BUENA VISTA GROUP, LLC
Active
Organization
BUENA VISTA GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM EVANS MD (MD/OWNER)
(708) 481-4200
Entity
Organization
Contact information
Practice address
418 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1739
(708) 481-4200
(708) 481-3302
Mailing address
3740 N LAKE SHORE DR APT 8A, CHICAGO, IL 60613-4201
(708) 481-4200
(708) 481-3302
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
IL
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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