Individual
PETULIA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9550 S EMERALD AVENUE, CHICAGO, IL 60628-1026
(312) 662-3664
Mailing address
9550 S EMERALD AVENUE, STE G, CHICAGO, IL 60628-1026
(312) 662-3664
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
049163422
IL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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