Provider Demographics
NPI:1568941763
Name:NORD-ENGLAND, EVELYN MARGARET (DMD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MARGARET
Last Name:NORD-ENGLAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GALVA
Mailing Address - State:IL
Mailing Address - Zip Code:61434-1766
Mailing Address - Country:US
Mailing Address - Phone:309-932-2000
Mailing Address - Fax:
Practice Address - Street 1:1237 SWEETBRIAR PL
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2343
Practice Address - Country:US
Practice Address - Phone:309-342-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist