Evans, Lisa

Evans, Lisa is an individual health care provider with primary practice located at 2300 N Rockton Ave , Rockford IL 61103-3619. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Evans, Lisa can be contacted via phone (815) 971-2000.

Contact Information

Primary practice address
2300 N Rockton Ave Rockford IL 61103-3619
Phone: (815) 971-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X 209006345 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209006345 Illinois

Profile Details

NPI number 1750539078
LBN Legal business name Evans, Lisa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2008
Last updated May 28th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750539078 NPPES
Illinois Other 209006345 LICENSE

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