Active NPI
Bradley Murray Evangelista
- Professional Counselor
- Oak Park, IL
National Provider Identifier
1992505408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178021384
- Practice address
- 533 S Humphrey Ave
Oak Park, IL 60304-1712 - Phone
- (847) 366-1227
- NPI assigned
- Mar 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178021384 | IL | Primary |
Addresses
Primary practice location
533 S Humphrey Ave
Oak Park, IL 60304-1712
Mailing address
533 S Humphrey Ave
Oak Park, IL 60304-1712
Phone (847) 366-1227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178021384 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743897600000",
"number": "1992505408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 S HUMPHREY AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041712",
"telephone_number": "847-366-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 S HUMPHREY AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041712",
"telephone_number": "847-366-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "BRADLEY",
"middle_name": "MURRAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-14",
"last_updated": "2025-04-06",
"certification_date": "2025-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178021384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.