EVERGREEN MEDICAL LTD. NPI 1245237460

NPI Information

  • NPI: 1245237460
  • Provider Name: EVERGREEN MEDICAL, LTD.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: EVERGREEN FAMILY MEDICINE
  • Address: 2850 W 95TH ST
    SUITE 403
    EVERGREEN PARK, IL
    ZIP 60805
  • Phone: (708) 423-2662

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NPI Details

EVERGREEN MEDICAL, LTD. is a family medicine in Evergreen Park, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EVERGREEN MEDICAL, LTD. NPI is 1245237460. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Evergreen Family Medicine.

The provider's business location address is:

2850 W 95TH ST
SUITE 403
EVERGREEN PARK, IL
ZIP 60805-735
Phone: (708) 423-2662
Fax: (708) 422-7264

The provider's authorized official is John R Elsen .
The authorized official title is President and has the following contact phone number (708) 423-2662.

The enumeration date for this NPI number is 7/1/2005 and was last updated on 3/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine042-618475ILLINOISYes

What is NPI?

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This page was last updated on: 11/21/2025

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