Provider Demographics
NPI:1851551642
Name:HARVEY, ALAN ANDREAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ANDREAS
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 RIDGE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2477
Mailing Address - Country:US
Mailing Address - Phone:847-328-8899
Mailing Address - Fax:847-563-1350
Practice Address - Street 1:2500 RIDGE AVE STE 302
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2477
Practice Address - Country:US
Practice Address - Phone:847-328-8899
Practice Address - Fax:847-563-1350
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021002718261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery