Individual
CAMILO EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
(312) 238-1000
Mailing address
345 E SUPERIOR ST, CHICAGO, IL 60611-2654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016951
IL
Other
Enumeration date
04/03/2009
Last updated
04/03/2009
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