Organization
CITY OF EVANSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA BUSH (CHIEF, COMMUNITY HEALTH SERVICES)
(847) 328-2100
Entity
Organization
Contact information
Practice address
2100 RIDGE AVE, CHILDREN'S DENTAL CLINIC, EVANSTON, IL 60201-2716
(847) 866-2953
(847) 448-8134
Mailing address
2100 RIDGE AVE, CHILDREN'S DENTAL CLINIC, EVANSTON, IL 60201-2716
(847) 866-2953
(847) 448-8134
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
IL
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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