Evelake, Inc.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

EVELAKE, INC.

Doing business as

Evelake

Practice address

8030 Old Cedar Ave S Ste 110
Bloomington, MN 55425-1214

Phone

(612) 200-7058

Fax

(952) 426-4935

NPI assigned

Feb 14, 2024

Organization subpart

No

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

Authorized official

Name

Ilhan Ahmed

Title

Ceo

Phone

(612) 200-7058

Specialties & licenses 1

Addresses

Other names 1

• Evelake Doing business as

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1770348294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 OLD CEDAR AVE S STE 110",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251214",
            "telephone_number": "612-200-7058",
            "fax_number": "952-426-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 OLD CEDAR AVE S STE 110",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251214",
            "telephone_number": "612-200-7058",
            "fax_number": "952-426-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELAKE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "ILHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-200-7058"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evelake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tavares Euells
• Anthonia Olatinka Evans
• Heather Evans
• Jeffrey John Evans, M.S., CCC-SLP
• Patricia Evans, PHD, LP
• Jon Evenson, RPH
• Zoe Katherine Everett
• Rachel Evers
• Gracen Taylor Eveslage, PT
• Evexia RX, LLC

• Early Intervention Provider Agency in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.