Individual
DEREK EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
1800 W ERIE ST APT 2, CHICAGO, IL 60622-6787
(815) 508-8440
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007034
IL
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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