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General NPI Number Information
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NPI Number | 1366355760
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Entity Type | Individual
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Provider Name | EVELYN MANDUJANO LSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 110 N BROCKWAY ST STE 300
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City | PALATINE
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State | IL
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Zip | 60067-5063
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Country | US
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Telephone | 847-485-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 2918 N MAJOR AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5224
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Country | US
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Telephone | 773-584-2553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 150130924
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License Number State | IL
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