Healthcare Provider Details

I. General information

NPI: 1518215714
Provider Name (Legal Business Name): EVE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20303 CRAWFORD AVE SUITE 210
OLYMPIA FIELDS IL
60461-1041
US

IV. Provider business mailing address

20303 CRAWFORD AVE SUITE 210
OLYMPIA FIELDS IL
60461-1041
US

V. Phone/Fax

Practice location:
  • Phone: 708-365-8281
  • Fax:
Mailing address:
  • Phone: 708-365-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number181000115
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANNINE OGLE
Title or Position: OWNER
Credential: DN
Phone: 708-365-8281