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General NPI Number Information
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NPI Number | 1184508855
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Entity Type | Organization
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Legal Business Name | EVOLUTIONARY HEALTHCARE, PLLC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1200 E TREMONT ST
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City | HILLSBORO
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State | IL
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Zip | 62049-1912
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Country | US
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Telephone | 217-532-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 8530 TERRACOTTA PL
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City | O FALLON
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State | IL
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Zip | 62269-4138
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Country | US
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Telephone | 618-960-1185
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | KEVIN STEIN
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Credential |
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Telephone | 618-960-1185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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