Provider Demographics
NPI:1245323260
Name:HOOVER, EVE B (PA)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:B
Last Name:HOOVER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:B
Other - Last Name:MECHANIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2319 OLD PLANK RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:62233
Mailing Address - Country:US
Mailing Address - Phone:618-826-2388
Mailing Address - Fax:618-826-3350
Practice Address - Street 1:2319 OLD PLANK RD
Practice Address - Street 2:CHESTER CLINIC PC
Practice Address - City:CHESTER
Practice Address - State:IL
Practice Address - Zip Code:62233
Practice Address - Country:US
Practice Address - Phone:618-826-2388
Practice Address - Fax:618-826-3350
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P22419Medicare UPIN
625400Medicare ID - Type Unspecified