NPIMap

Organization Active NPI

Evohome Medical Corporation

Doing business as EvoHome Medical Group

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1346036720
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EVOHOME MEDICAL CORPORATION
Doing business as
EvoHome Medical Group
Practice address
400 N May St Ste 201
Chicago, IL 60642-6495
Phone
(800) 766-0666
Fax
(800) 297-0666
NPI assigned
Apr 15, 2025
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark P Libke
Title
Authorized Official
Phone
(312) 265-1532

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

400 N May St Ste 201
Chicago, IL 60642-6495

Mailing address

400 N May St Ste 201
Chicago, IL 60642-6495
Phone (888) 491-6729

Other names 1

  • EvoHome Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250709003449 IL Part B Supplier - Clinic/Group Practice 4486168515 Receives reassigned benefits from 13 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

400 N May St
Ste 201
Chicago, IL 60642
Phone (888) 491-6729

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1346036720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MAY ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606426495",
            "telephone_number": "888-491-6729",
            "fax_number": "888-491-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAY ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606426495",
            "telephone_number": "800-766-0666",
            "fax_number": "800-297-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOHOME MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "LIBKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "312-265-1532"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvoHome Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.