| Organization Name: | ISABELO M EVANGELISTA |
| NPI Number: | 1073770459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ISABELO M EVANGELISTA (MEDICAL DOCTOR) |
| Mailing Address: | 540 Aster Ln Hoffman Estates |
| State: | IL US |
| Postal Code: | 601694413 |
| Phone Number: | 8478283847 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2008 |
| NPI Last Update Date: | 05/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |