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Individual

DR. EVANS Z FIAKPUI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
1851 SIBLEY BLVD, CALUMET CITY, IL 60409-2252
(708) 868-2300
(708) 868-2304
Mailing address
1851 SIBLEY BLVD, CALUMET CITY, IL 60409-2252
(708) 868-2300
(708) 868-2304

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36-2838347
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036045042
IL
01
21603450
BLUECROSS BLUESHIELD
IL
Enumeration date
08/05/2006
Last updated
10/30/2015
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