Basic Information
| Provider Information | |||||||||
| NPI: | 1639847551 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAVES HEALTH PARTNERS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5151 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479339200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5151 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479339200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2021 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | RADJA | ||||||||
| AuthorizedOfficialFirstName: | MARCIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3124205494 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
| NPICertificationDate: | 11/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.