# EVOLVE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316588841
- **Authorized official:** MR. JESUS JOEL MANAGUELOD OTR/L (PRESIDENT)
- **Authorized official phone:** (312) 278-7138

## Contact information

- **Practice address:** 4535 N MARMORA AVE, CHICAGO, IL 60630-3138
- **Practice address phone:** (312) 278-7138
- **Practice address fax:** (708) 776-7816
- **Mailing address:** 4535 N MARMORA AVE, CHICAGO, IL 60630-3138
- **Mailing address phone:** (312) 278-7138
- **Mailing address fax:** (708) 776-7816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 10/07/2019
- **Last updated:** 10/07/2019