# EVERNORTH CARE PROVIDERS - DELAWARE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760131197
- **Authorized official:** JACQUELINE D LAKES (SENIOR PARALEGAL)
- **Authorized official phone:** (954) 446-0640

## Contact information

- **Practice address:** 9350 S 150 E STE 700, SANDY, UT 84070-2715
- **Practice address phone:** (773) 292-4800
- **Practice address fax:** (312) 564-4059
- **Mailing address:** 730 COOL SPRINGS BLVD STE 500, FRANKLIN, TN 37067-7331
- **Mailing address phone:** (773) 292-4800
- **Mailing address fax:** (312) 564-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | — |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 03/22/2022
- **Last updated:** 07/14/2025