NPI

Justin Ryan Gavino Andrada

This page is a copy of the public NPPES file.

Facts

Status
Active
Credential
D.O.
Type
Individual
Enumeration date
2021-05-30
Last updated
2026-02-18

Specialties

Licenses

License IL
036177051

Location

Practice location
1007 Church St Ste 100
City
Evanston IL
Postal code
60201-5910
Phone
(847) 475-4555

Medicare

PECOS
A PECOS enrollment row matches this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.

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Other NPIs in Evanston, IL. 4,875 records in the public file.

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