NPIMap

Organization Active NPI

William B Evans MD SC

  • Nephrology Physician
  • Matteson, IL
National Provider Identifier
1962492785
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
WILLIAM B EVANS MD SC
Practice address
4647 Lincoln Hwy
Matteson, IL 60443-2319
Phone
(708) 481-4200
Fax
(708) 481-3302
NPI assigned
Oct 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
William B Evans, M.D.
Title
President
Phone
(708) 481-4200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4647 Lincoln Hwy
Matteson, IL 60443-2319

Mailing address

PO Box 429
Matteson, IL 60443-0429
Phone (708) 747-5850

Other identifiers 1

IdentifierTypeStateIssuer
01622854OtherBCBSIL GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

2310 York St
#2A
Blue Island, IL 60406
Phone (708) 204-0786

4647 Lincoln Hwy
Matteson, IL 60443
Phone (708) 481-9912

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962492785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430429",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432319",
            "telephone_number": "708-481-4200",
            "fax_number": "708-481-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM B EVANS MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-481-4200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP NUMBER",
            "identifier": "01622854",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.