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Individual

KENNETH MARCUS EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-6162
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-6162

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010015
IL
363A00000X
Physician Assistant
Primary

Other

Enumeration date
08/01/2023
Last updated
03/02/2026
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