Evan James Panken, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

125.078073 Issued in IL

Practice address

251 E Huron St
Chicago, IL 60611-2908

Phone

(312) 503-7975

NPI assigned

Sep 4, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1504483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1174041784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E HURON STREET, SUITE 1-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-503-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKEN",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-04",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125.078073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Silvia Z Panitch, M.D.
• William R Panje, MD
• Anjana Sahani Panjwani, M.D.
• Sameer Panjwani, M.D.
• Jennifer Drake Pankau, LICSW
• Ashley Nicole Pankey
• Audrey Joan Panko, MD
• Silvana Pannain
• Amy L Pannaralla
• Janet Pannaralla, D.D.S.

• Urology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.