Provider Demographics
NPI:1801101720
Name:SERAG, EVELYN GRACE NARTATEZ (MD)
Entity type:Individual
Prefix:
First Name:EVELYN GRACE
Middle Name:NARTATEZ
Last Name:SERAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVELYN GRACE
Other - Middle Name:ESTRADA
Other - Last Name:NARTATEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3224 W ARMITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3716
Mailing Address - Country:US
Mailing Address - Phone:773-645-0096
Mailing Address - Fax:773-645-0113
Practice Address - Street 1:3224 W ARMITAGE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3716
Practice Address - Country:US
Practice Address - Phone:773-645-0096
Practice Address - Fax:773-645-0113
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449536207Q00000X
390200000X
IL036141851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program