Organization
EVANSTON HOSPITAL CORPORATION
Active
Other names
Evanston Regional Hosp - ER Dept
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PORTACCI (PRESIDENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
190 ARROWHEAD DR, EVANSTON, WY 82930-9266
(307) 783-8161
(307) 783-8237
Mailing address
PO BOX 60000, FILE 0074044, SAN FRANCISCO, CA 94160-0001
(800) 819-2547
(423) 899-5295
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
WY
Other
Enumeration date
06/21/2006
Last updated
07/21/2022
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