Individual
RENEE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-4252
Mailing address
251 EAST HURON, CHICAGO, IL 60611-2908
(312) 926-2808
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209009104
IL
364SA2100X
Acute Care Clinical Nurse Specialist
209009104
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396014650
—
IL
Enumeration date
12/15/2011
Last updated
11/27/2018
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