OrganizationActive
Evanston Periodontics, LLC
NPI 1669499505 · Periodontics · Evanston, IL
Provider details
- NPI number
- 1669499505
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Roger Nouneh, Managing Member(312) 927-8882
Specialties & taxonomies
Dental Providers
Practice location
636 Church St
Suite # 722
Evanston, IL 60201-4508
Phone: (847) 475-7754
Fax: (847) 475-4725
Approximate (ZIP-level) locationGet directions
Mailing address
636 Church St
Evanston, IL 60201-4508
Registry dates
- Enumerated
- 2006-07-16
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.