Mandi E Evanson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013320 Issued in IL

Practice address

4700 W 95TH St
Suite 104
Oak Lawn, IL 60453-2533

Phone

(708) 202-9922

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1811040652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N OAK PARK AVE",
            "address_2": "1B",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022157",
            "telephone_number": "248-420-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W 95TH ST",
            "address_2": "SUITE 104",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532533",
            "telephone_number": "708-202-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANSON",
        "first_name": "MANDI",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.010889",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andriana Mae Evangelopoulos, CCC-SLP
• Diana Murcia Evans, PA-C
• E'Ara Nyea Evans
• Jacqueline M Evans, APN/CPNP
• Zariah Evans
• Even Care Labs Inc
• Glynis Everett
• Evergreen Health Cre
• Janie I Exner, MS, LCPC
• Leon Eydelman, MD

• Clinical Social Worker in Oak Lawn, IL
• Providers in Oak Lawn, 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 Dec 8, 2008; 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.