# CITY OF EVANSTON HEALTH DEPARTMENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evanston Childrens Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790095065
- **Authorized official:** MS. EVONDA THOMAS RN MSN DHA(C) (DIRECTOR)
- **Authorized official phone:** (847) 844-2957

## Contact information

- **Practice address:** 2100 RIDGE AVE, EVANSTON, IL 60201-2716
- **Practice address phone:** (847) 866-2057
- **Practice address fax:** (847) 448-8125
- **Mailing address:** 2100 RIDGE AVE, ROOM G-500, EVANSTON, IL 60201-2716
- **Mailing address phone:** (847) 866-2957
- **Mailing address fax:** (847) 448-8125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 074390907 | IL | Yes |

## Other

- **Enumeration date:** 10/20/2010
- **Last updated:** 10/20/2010