Provider Demographics
NPI:1861599672
Name:BOWMAN-GOONE, EVELYN GLORIA (DC)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:GLORIA
Last Name:BOWMAN-GOONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W HAWTHORNE ST APT F
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1053
Mailing Address - Country:US
Mailing Address - Phone:312-316-0075
Mailing Address - Fax:
Practice Address - Street 1:1157 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6516
Practice Address - Country:US
Practice Address - Phone:877-542-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor