Healthcare Provider Details

I. General information

NPI: 1134997414
Provider Name (Legal Business Name): EVAN C ALLING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W GALENA BLVD
AURORA IL
60506-4305
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 630-692-5960
  • Fax: 630-692-5961
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209032549
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: