Kristoffer Evangelista, BA PSYCHOLOGY

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.016329 Issued in IL

Practice address

3545 Lake Ave
Wilmette, IL 60091-1058

Phone

(847) 386-6560

NPI assigned

Jul 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Bird Day LLC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1588030621
  NPD (past)

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1669968541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LAKE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911058",
            "telephone_number": "847-386-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LAKE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911058",
            "telephone_number": "847-386-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "KRISTOFFER",
        "name_prefix": "Mr.",
        "credential": "BA PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.016329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Engelman
• Jimena Ines Escurra, LCPC
• Samantha Marie Espinoza, DNP PNP-PC
• Nina Esshaki, LPC
• Morgan Etheridge
• Alia Ezziddin, DMD
• Faith Mitchel Fairclough, RN BSN IBCLC
• Charles Michael Falcone
• Mitra Farahati, MD
• Carol Feiss, PSYD

• Occupational Therapy Assistant in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.