Provider Demographics
NPI:1710622329
Name:STOOPS, EVA GRAY (MD)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:GRAY
Last Name:STOOPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 W ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-3910
Mailing Address - Country:US
Mailing Address - Phone:773-440-1681
Mailing Address - Fax:
Practice Address - Street 1:755 QUEENSWAY E
Practice Address - Street 2:UNIT 6 AND 7
Practice Address - City:MISSISSAUGA
Practice Address - State:ONTARIO
Practice Address - Zip Code:L4Y4C5
Practice Address - Country:CA
Practice Address - Phone:905-896-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL125.080222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program