Provider Demographics
NPI:1174666051
Name:EVANS FORBES, MEGGAN M (APN-BC)
Entity Type:Individual
Prefix:MRS
First Name:MEGGAN
Middle Name:M
Last Name:EVANS FORBES
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:MRS
Other - First Name:MEGGAN
Other - Middle Name:M
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14035 BUNRATTY DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-7405
Mailing Address - Country:US
Mailing Address - Phone:708-364-0073
Mailing Address - Fax:
Practice Address - Street 1:14035 BUNRATTY DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-7405
Practice Address - Country:US
Practice Address - Phone:708-364-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41-312029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily