Individual
JERUSHA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1343 DARTMOUTH RD, FLOSSMOOR, IL 60422-1904
(773) 490-6904
Mailing address
1343 DARTMOUTH RD, FLOSSMOOR, IL 60422-1904
(773) 490-6904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.108812
IL
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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