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General NPI Number Information
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NPI Number | 1194008425
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Entity Type | Individual
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Provider Name | KENYATTA EVANS-SNULLIGAN NP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1100 W CERMAK RD CUITE C119
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City | CHICAGO
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State | IL
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Zip | 60608-4500
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Country | US
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Telephone | 312-243-2223
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Fax | 312-243-2227
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 041361698
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 209-008944
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License Number State | IL
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