MEDICARE: MS. PATRICIA O'DEA-EVANS R.N.,CCM,PMHNP, LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225800000X	Recreation Therapist		IL
2	101YM0800X	Mental Health Counselor	180.003449	IL
3	163WA2000X	Administrator Registered Nurse	240972	WI
4	163WC0400X	Case Management Registered Nurse	041-354355	IL
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	17704-33	WI

General Provider Information

NPI Number	:	1588995922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA O'DEA-EVANS R.N.,CCM,PMHNP, LCPC

Provider Business Mailing Address
First Line	:	2118 PLUM GROVE RD # 110
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1932
Country	:	US
Telephone Number	:	847-373-1712
Fax Number	:	847-346-1901

Provider Business Practice Location Address
First Line	:	2118 PLUM GROVE RD # 110
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1932
Country	:	US
Telephone Number	:	847-373-1712
Fax Number	:	847-346-1901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2010
Last Update Date	:	02/03/2026

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