# EVOLA PEDIATRIC THERAPY

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

## Provider details

- **NPI number:** 1417221854
- **Authorized official:** MRS. ANGELA EVOLA ESCHER MS, OTR/L (PRESIDENT)
- **Authorized official phone:** (847) 971-3771

## Contact information

- **Practice address:** 1820 W WEBSTER AVE, CHICAGO, IL 60614-2934
- **Practice address phone:** (847) 971-3771
- **Mailing address:** 5455 N LINDEN AVE, CHICAGO, IL 60656-1615
- **Mailing address phone:** (847) 971-3771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 056007626 | IL | Yes |

## Other

- **Enumeration date:** 03/02/2012
- **Last updated:** 03/02/2012