Provider Demographics
NPI:1699111401
Name:EVAN J. SAMETT M.D.S.C.
Entity type:Organization
Organization Name:EVAN J. SAMETT M.D.S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAMETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-323-7166
Mailing Address - Street 1:205 E BUTTERFIELD RD # 461
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5103
Mailing Address - Country:US
Mailing Address - Phone:973-552-8427
Mailing Address - Fax:312-278-0354
Practice Address - Street 1:8319 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1605
Practice Address - Country:US
Practice Address - Phone:847-323-7166
Practice Address - Fax:312-278-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty