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NPI Code Detail

MEDICARE: JOSHUA MICHAEL EVERHART DO

MEDICARE: JOSHUA MICHAEL EVERHART DO
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
1207Q00000XFamily Medicine Physician5101017552MI
2207R00000XInternal Medicine Physician5101017552MI
3207Q00000XFamily Medicine Physician036134050IL

General Provider Information

NPI Number : 1457537011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MICHAEL EVERHART DO
Provider Business Mailing Address
First Line : 2734 W 87TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-3937
Country : US
Telephone Number : 773-918-4700
Fax Number : 773-313-3763
Provider Business Practice Location Address
First Line : 2734 W 87TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-3937
Country : US
Telephone Number : 773-918-4700
Fax Number : 773-313-3763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2008
Last Update Date : 02/01/2022

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Directions to “ JOSHUA MICHAEL EVERHART DO” Practice Location

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