NPIMap

Organization Active NPI

City of Evanston

  • State or Local Public Health Clinic/Center
  • Evanston, IL
National Provider Identifier
1790957884
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
CITY OF EVANSTON
Practice address
2100 Ridge Ave
Children'S Dental Clinic
Evanston, IL 60201-2716
Phone
(847) 866-2953
Fax
(847) 448-8134
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carla Bush
Title
Chief, Community Health Services
Phone
(847) 328-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X IL Primary

Addresses

Primary practice location

2100 Ridge Ave
Children'S Dental Clinic
Evanston, IL 60201-2716

Mailing address

2100 Ridge Ave
Children'S Dental Clinic
Evanston, IL 60201-2716
Phone (847) 866-2953

National Provider Directory

National Provider Directory
Tax ID family
Evanston Fire Departmen3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1790957884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 RIDGE AVE",
            "address_2": "CHILDREN'S DENTAL CLINIC",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012716",
            "telephone_number": "847-866-2953",
            "fax_number": "847-448-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RIDGE AVE",
            "address_2": "CHILDREN'S DENTAL CLINIC",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012716",
            "telephone_number": "847-866-2953",
            "fax_number": "847-448-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EVANSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CHIEF, COMMUNITY HEALTH SERVICES",
        "authorized_official_telephone_number": "847-328-2100"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.