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General NPI Number Information
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NPI Number | 1851639389
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Entity Type | Individual
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Provider Name | DANIEL C. EVITTS H.I.S.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 988 LAKE ST
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City | ROSELLE
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State | IL
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Zip | 60172-3354
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Country | US
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Telephone | 630-351-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1129 ROSLYN LN
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City | SCHAUMBURG
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State | IL
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Zip | 60194-4250
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Country | US
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Telephone | 847-781-0989
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 0373048
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License Number State | IL
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