Healthcare Provider Details

I. General information

NPI: 1609275098
Provider Name (Legal Business Name): EVIDENCE BASED SOLUTIONS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WEST ST STE 1200
WILMINGTON DE
19801-1058
US

IV. Provider business mailing address

1000 N WEST ST STE 1200
WILMINGTON DE
19801-1058
US

V. Phone/Fax

Practice location:
  • Phone: 855-872-2711
  • Fax: 855-872-2712
Mailing address:
  • Phone: 855-872-2711
  • Fax: 855-872-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL CHILLEMI
Title or Position: CEO
Credential: DC
Phone: 855-872-2711