Provider Demographics
NPI:1386465482
Name:CHICAS, EVELYN GISSELLE
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:GISSELLE
Last Name:CHICAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:VOLO
Mailing Address - State:IL
Mailing Address - Zip Code:60020-3412
Mailing Address - Country:US
Mailing Address - Phone:224-203-9067
Mailing Address - Fax:
Practice Address - Street 1:1439 PRESCOTT DR
Practice Address - Street 2:
Practice Address - City:VOLO
Practice Address - State:IL
Practice Address - Zip Code:60020-3412
Practice Address - Country:US
Practice Address - Phone:224-203-9067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209030830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily