Evisha Shavonn Ford

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011399 Issued in IL

Practice address

18501 Maple Creek Dr Ste 200
Tinley Park, IL 60477-6779

Phone

(708) 798-4200

NPI assigned

May 30, 2018

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Ican Dream Center NFP

  • Community/Behavioral Health Agency
  • Hazel Crest, IL
  • NPI 1114415080
  NPD Authorized official
• Ican Dream Foundation Inc

  • Adult Mental Health Clinic/Center
  • Tinley Park, IL
  • NPI 1720973084
  NPD Authorized official
• Radiant Minds Institute Corp

  • Multi-Specialty Clinic/Center
  • Tinley Park, IL
  • NPI 1811774946

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1720570401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 MACDONALD LN",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221340",
            "telephone_number": "708-307-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 MAPLE CREEK DR STE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776779",
            "telephone_number": "708-798-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "EVISHA",
        "middle_name": "SHAVONN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Fitzsimons, PT, DPT
• Flores Medical Services, Inc.
• Ledonna V. Flynn
• Rasa Fokas, MPT
• Lindsey A Folk, L.P.C.
• Marissa Lashell Ford, OTR/L
• Steven Michael Ford, EMT-P, CCEMT-P, NRP
• Janyah Forrest
• Kristen L Forsythe
• Emily Foster

• Clinical Social Worker in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.