| City Of Evanston | |
|
2100 Ridge Ave Children's Dental Clinic Evanston IL 60201-2716 | |
| (847) 866-2953 | |
| (847) 448-8134 |
| Full Name | City Of Evanston |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 2100 Ridge Ave, Evanston, Illinois |
| Authorized Official Name and Position | Carla Bush (CHIEF, COMMUNITY HEALTH SERVICES) |
| Authorized Official Contact | 8473282100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of Evanston 2100 Ridge Ave Children's Dental Clinic Evanston IL 60201-2716 Ph: (847) 866-2953 | City Of Evanston 2100 Ridge Ave Children's Dental Clinic Evanston IL 60201-2716 Ph: (847) 866-2953 |
| NPI Number | 1790957884 |
|---|---|
| Provider Enumeration Date | 03/28/2008 |
| Last Update Date | 03/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790957884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (Illinois) | Primary |
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