NPIMap

Individual provider Active NPI

Anthony T McCormack, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Park Ridge, IL
National Provider Identifier
1154388791
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036-077374 Issued in IL
Practice address
1875 Dempster St Ste 520
Park Ridge, IL 60068-1130
Phone
(847) 720-6464
Fax
(847) 720-6463
NPI assigned
Apr 27, 2006
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036077374 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036-077374 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste 520
Park Ridge, IL 60068-1130

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

241 W Weaver Rd
Suite 240
Forsyth, IL 62535-9762
Phone (217) 876-6350

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address amccormack265746@direct.myadvocateaurora.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507000610 IL Practitioner - Geriatric MedicinePractitioner - Family Practice 4082603881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Illinois Medical College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1875 Dempster St
Suite 550
Park Ridge, IL 60068-1188
Phone (847) 384-1420

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-077374ILMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jun 13, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jun 13, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine PastSince Aug 1, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1775 Ballard Rd
Lowr
Park Ridge, IL 60068
Phone (847) 698-5500

1875 W Dempster St
Ste 520
Park Ridge, IL 60068
Phone (847) 720-6464

1875 W Dempster St
Ste 550
Park Ridge, IL 60068
Phone (847) 384-1420

Interoperability endpoints

  • Direct secure messaging: amccormack265746@direct.myadvocateaurora.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1154388791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 520",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681130",
            "telephone_number": "847-720-6464",
            "fax_number": "847-720-6463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 W Weaver Rd",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "IL",
            "postal_code": "625359762",
            "country_code": "US",
            "telephone_number": "217-876-6350",
            "fax_number": "217-876-6355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "ANTHONY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036077374",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036-077374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 520",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amccormack265746@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 520",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.