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Individual

DR. CARLOTTA ANN EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
801 S PAULINA ST, MC 841, CHICAGO, IL 60612-7210
(312) 996-7138
(312) 996-0873
Mailing address
801 S PAULINA ST, MC 841, CHICAGO, IL 60612-7210
(312) 996-7138
(312) 996-0873

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021-001786
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A2741KD1
IL
Enumeration date
10/25/2005
Last updated
09/09/2014
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