Provider Demographics
NPI:1447211198
Name:EVANS, JOILYNN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JOILYNN
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOILYNN
Other - Middle Name:M
Other - Last Name:GILLESPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4123 DUTCHMANS LANE
Practice Address - Street 2:SUITE 507
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4730
Practice Address - Country:US
Practice Address - Phone:402-423-9595
Practice Address - Fax:502-719-0161
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40360207V00000X, 207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65925109OtherMEDICAID GRP
KY7100010330Medicaid
KY7136702OtherCIGNA-WS
KY000000724270OtherANTHEM - WS
IN201036270Medicaid
KY50012915OtherPASSPORT
5581OtherMEDICARE GRP
KY127010OtherSIHO - WS
KY50034483OtherPASSPORT - WS
KY000057120LOtherHUMANA - WS
KY000057120LOtherHUMANA - WS
KY7100010330Medicaid
1558109Medicare PIN