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Evan Fuchs

General Practice β€’ Great Lakes, IL

Active NPI 1134823578 Individual Practitioner Male Practitioner
Practice location in NPPES

3410 Illinois St
Great Lakes, IL 600883120

Call 8473400495 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3410 Illinois St

Great Lakes, IL 600883120

Telephone 8473400495

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Great Lakes and Illinois

6 active clinicians are listed under General Practice with a practice address in Great Lakes, IL (291 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-10-28
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

License # reported to NPPES AZ 73278

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Military Health Care Provider

NUCC Taxonomy Code: 171000000X

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Adam Dziedzic , PA-C

Physician Assistant

NPI 1104935899

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location October 28, 2024

Registered at 3410 ILLINOIS ST, GREAT LAKES, IL 600883120 (Tel: 8473400495)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2023

Military Health Care Provider

βœ…
NPI Profile Active March 29, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 29, 2023

Registered at H200 MERCY CIRCLE, CAMP PENDLETON, CA 92055 (Tel: 5756804268)

πŸ“
Business Mailing Address (Initial Record) March 29, 2023

Registered at H200 MERCY CIRCLE, CAMP PENDLETON, CA 92055

πŸ‘€
Provider Name / Credentials (Initial Record) March 29, 2023

Recorded as EVAN FUCHS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 29, 2023

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration March 29, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1134823578
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 29, 2023
Last Update: October 28, 2024
Sole Proprietor: No

Mailing Address

H200 Mercy Circle

Camp Pendleton, CA 92055

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.