Stevens, Dominique Maya

Stevens, Dominique Maya is an individual health care provider with primary practice located at 633 Emerson St , Evanston IL 60208-0844. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Stevens, Dominique Maya can be contacted via phone (847) 491-5470.

Contact Information

Primary practice address
633 Emerson St Evanston IL 60208-0844
Phone: (847) 491-5470
Fax: (847) 491-5919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036154015 Illinois

Profile Details

NPI number 1346604725
LBN Legal business name Stevens, Dominique Maya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2016
Last updated Dec 7th, 2021 - about 4 years 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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