Individual
KRISTINE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2813 MILLER RD, MARENGO, IL 60152-9245
(847) 507-9205
Mailing address
2813 MILLER RD, MARENGO, IL 60152-9245
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
03/03/2020
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