MEDICARE: CHRISTOPHER J. EVANICH M.D.

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	207X00000X	Orthopaedic Surgery Physician	32282	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760451850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J. EVANICH M.D.

Provider Business Mailing Address
First Line	:	3077 N MAYFAIR RD STE 305
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53222-4305
Country	:	US
Telephone Number	:	414-384-6700
Fax Number	:	414-727-1058

Provider Business Practice Location Address
First Line	:	3237 S 16TH ST
Second Line	:	SUITE 210
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-4526
Country	:	US
Telephone Number	:	414-384-6700
Fax Number	:	414-384-3008

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	02/25/2020

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