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Organization

BUENA VISTA GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM EVANS MD (MD/OWNER)
(708) 481-4200
Entity
Organization

Contact information

Practice address
418 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1739
(708) 481-4200
(708) 481-3302
Mailing address
3740 N LAKE SHORE DR APT 8A, CHICAGO, IL 60613-4201
(708) 481-4200
(708) 481-3302

Taxonomy

Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
IL

Other

Enumeration date
02/28/2018
Last updated
02/28/2018
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