Provider Demographics
NPI:1306960711
Name:EVARTS, KATHERINE GRABER (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:GRABER
Last Name:EVARTS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:GRABER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:830 WEST END CT
Mailing Address - Street 2:SUITE 175
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1382
Mailing Address - Country:US
Mailing Address - Phone:847-367-4920
Mailing Address - Fax:847-367-4943
Practice Address - Street 1:830 WEST END CT
Practice Address - Street 2:SUITE 175
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1382
Practice Address - Country:US
Practice Address - Phone:847-367-4920
Practice Address - Fax:847-367-4943
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics