Individual
EVA LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 MACARTHUR BLVD STE 305, MUNSTER, IN 46321-2920
(219) 703-2401
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003347A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/27/2021
Last updated
09/17/2021
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