MEDICARE: EVOLVE BEHAVIORAL & MENTAL HEALTH LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1811849045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVOLVE BEHAVIORAL & MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	4610 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 ASBURY AVENUE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202
Country	:	US
Telephone Number	:	312-806-1931
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GANIU J AJAKAIYE
Credential	:	NP
Telephone Number	:	312-806-1931

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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