Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209017303 | IL |
NPI | 1003310269 |
---|---|
Provider Name | Evelyn H Chou |
First Address | Savoy, IL 61874-9510 |
Second Address | Savoy, IL 61874-9510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 02/09/2020 |