Individual
EVANGELENE EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
929 W FOSTER AVE, CHICAGO, IL 60640-1491
(773) 433-1800
Mailing address
5915 N CAMPBELL AVE APT 2, CHICAGO, IL 60659-5062
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.006234
IL
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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