Provider Demographics
NPI:1457693764
Name:EVANS, MICHAEL ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:225 E. CHICAGO AVENUE, BOX 19
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-5187
Mailing Address - Fax:312-227-9730
Practice Address - Street 1:225 E. CHICAGO AVENUE, 19
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-5187
Practice Address - Fax:312-227-9730
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA73233207L00000X
IL036.145481207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology