MEDICARE: EVERSET HEALTH - ILLINOIS PLLC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1972486454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERSET HEALTH - ILLINOIS PLLC

Provider Business Mailing Address
First Line	:	3 GRANT SQ # 135
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-3351
Country	:	US
Telephone Number	:	661-350-5424
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 N LAKE ST
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-3177
Country	:	US
Telephone Number	:	630-844-1244
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. KENNETH JOHNS
Credential	:	DC
Telephone Number	:	661-350-5424

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	07/30/2025

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