Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Evan James Fry, DMD

Individual provider General Practice Dentistry · NPI 1407422421

Dr. Evan James Fry, DMD is a Dentist in LA Grange, Illinois. Qualified in 2021, 5 years ago. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2021
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4727 Willow Springs Rd Ste 1N
LA Grange, IL 60525-6153
Phone: (708) 352-7358
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019.033103 (IL)
General Practice Dentistry Taxonomy 1223G0001X · Licence 319.022417 (IL)

Record details

NPI number1407422421
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 1, 2021
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024
Mailing address4727 Willow Springs Rd Ste 1n, La Grange, IL 60525-6153

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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