Individual provider Active NPI

Andrea D. Bennett, M.D.

  • Obstetrics & Gynecology Physician
  • Arlington Heights, IL
National Provider Identifier
1093755670
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036093312 Issued in IL
Practice address
800 W. Central Road
Northwest Community Hospital
Arlington Heights, IL 60005
Phone
(847) 618-1000
NPI assigned
Jun 8, 2006
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036093312 IL Primary

Addresses

Primary practice location

800 W. Central Road
Northwest Community Hospital
Arlington Heights, IL 60005

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abennett6665@direct.nch.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000050 IL Practitioner - Obstetrics/Gynecology 7012804982 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036093312ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Services Inc CurrentSince Sep 1, 2013 Accepting new patients
Endeavor Health Medical Group CurrentSince Oct 21, 2023 Accepting new patients
Northwest Community Health Services Inc CurrentSince Sep 1, 2013 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Current Accepting new patients
Women's Healthfirst L.L.C Obstetrics & Gynecology Past Accepting new patients
Northwest Community Physicians Association LLC Obstetrics & Gynecology Past Accepting new patients

Locations

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

600 W Lake Cook Rd
Ste 120
Buffalo Grove, IL 60089
Phone 8478088884 ext. 8134

25233 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: abennett6665@direct.nch.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1093755670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W. CENTRAL ROAD",
            "address_2": "NORTHWEST COMMUNITY HOSPITAL",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60005",
            "telephone_number": "847-618-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANDREA",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036093312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abennett6665@direct.nch.org",
            "affiliation": "N",
            "address_1": "800 W. Central Road",
            "address_2": "Northwest Community Hospital",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.