Organization
WILLIAM B EVANS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM B EVANS M.D. (PRESIDENT)
(708) 481-4200
Entity
Organization
Contact information
Practice address
4647 LINCOLN HWY, MATTESON, IL 60443-2319
(708) 481-4200
(708) 481-3302
Mailing address
PO BOX 429, MATTESON, IL 60443-0429
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622854
BCBSIL GROUP NUMBER
—
Enumeration date
10/24/2005
Last updated
04/20/2008
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