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General NPI Number Information
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NPI Number | 1477395523
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Entity Type | Individual
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Provider Name | EVAN HOCHEUL SHIN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/10/2024
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 7300 N WESTERN AVE STE J
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City | CHICAGO
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State | IL
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Zip | 60645-1833
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Country | US
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Telephone | 773-338-8433
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 ELLINWOOD AVE UNIT 539
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City | DES PLAINES
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State | IL
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Zip | 60016-5275
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Country | US
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Telephone | 734-709-5350
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014482A
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License Number State | IN
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