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Organization

CITY OF EVANSTON HEALTH DEPARTMENT

Active
Other names
Evanston Childrens Dental Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MS. EVONDA THOMAS RN MSN DHA(C) (DIRECTOR)
(847) 844-2957
Entity
Organization

Contact information

Practice address
2100 RIDGE AVE, EVANSTON, IL 60201-2716
(847) 866-2057
(847) 448-8125
Mailing address
2100 RIDGE AVE, ROOM G-500, EVANSTON, IL 60201-2716
(847) 866-2957
(847) 448-8125

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
074390907
IL

Other

Enumeration date
10/20/2010
Last updated
10/20/2010
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