Individual ProviderEvanna LerougeEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1901 W Harrison St, Chicago, IL 60612-3714(312) 864-6000PECOS EnrollmentBased on the most recent information from CMS, provider Evanna Lerouge is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1558945980Provider TypeIndividualFull NameLerouge, EvannaGenderFemaleSole ProprietorNoEnumeration Date5/11/2021Last Updated5/11/2021Contact InformationPractice LocationPractice Address1901 W Harrison St, Chicago, IL 60612-3714Phone(312) 864-6000FaxUnlisted FaxMailing LocationMailing Address1901 W Harrison St, Chicago, IL 60612-3714Phone(312) 864-6000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense125.077942Illinois