Provider Demographics
NPI:1699593343
Name:POWERS, EVA RENEE
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:RENEE
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:RENEE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:511 SPRINGBROOK TRAIL NORTH
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-4005
Mailing Address - Country:US
Mailing Address - Phone:630-561-8445
Mailing Address - Fax:
Practice Address - Street 1:511 SPRINGBROOK TRAIL NORTH
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-4005
Practice Address - Country:US
Practice Address - Phone:630-561-8445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health