Individual provider Active NPI

Janis Atkinson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Evanston, IL
National Provider Identifier
1093860892
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036076150 Issued in IL
Practice address
355 Ridge Ave
Evanston, IL 60202-3328
Phone
(847) 316-2284
Fax
(847) 316-2943
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036076150 IL Primary

Addresses

Primary practice location

355 Ridge Ave
Evanston, IL 60202-3328

Mailing address

100 Tristate International Ste 300
Lincolnshire, IL 60069-4419
Phone (847) 205-4700

Other identifiers 1

IdentifierTypeStateIssuer
01618679OtherILBLUE SHIELD

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
I20101116000664 IL Practitioner - Pathology 0042405094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Rush Medical College of Rush University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Pathology Consultants SCGroup PAC ID 8820286545, 3 clinicians

Practice addresses (Care Compare)

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-2284

Hospital & facility affiliations

  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036076150ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Pathology Consultants, S.C. Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 1987 Accepting new patients

Locations

355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-2329

100 Tristate International
Ste 300
Lincolnshire, IL 60069

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1093860892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TRISTATE INTERNATIONAL STE 300",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600694419",
            "telephone_number": "847-205-4700",
            "fax_number": "847-205-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-2284",
            "fax_number": "847-316-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "JANIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036076150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01618679",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.