Individual
MR. EVAN MICHAEL WHITENACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1611 W HARRISON ST, CHICAGO, IL 60612-4861
(224) 254-6076
Mailing address
2141 W EVERGREEN AVE, CHICAGO, IL 60622-3016
(248) 760-9191
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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