MEDICARE: MEGAN EVANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.031607	IL
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1205694320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN EVANS

Provider Business Mailing Address
First Line	:	1 E ERIE ST STE 525-4895
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E ERIE ST STE 525-4895
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2740
Country	:	US
Telephone Number	:	331-315-1334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	04/10/2026

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Directions to “ MEGAN EVANS ” Practice Location

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