Individual provider Active NPI

Hannah Bloom Lane, PA-C

  • Physician Assistant
  • Skokie, IL
National Provider Identifier
1215822580
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011302 Issued in IL
Practice address
9650 Gross Point Rd
Skokie, IL 60076-5080
Phone
(847) 982-6710
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085011302 IL Primary

Addresses

Primary practice location

9650 Gross Point Rd
Skokie, IL 60076-5080

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700

Other practice location 1

2100 Pfingsten Rd
Glenview, IL 60026-1301
Phone (847) 657-5800

Other practice location 2

9650 Gross Point Rd Ste 4900
Skokie, IL 60076-5080
Phone (847) 444-5300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002391 IL Practitioner - Physician Assistant 9133628514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Ohio University, College of Osteopathic Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2050 Pfingsten Rd
Suite 330
Glenview, IL 60026-1300
Phone (847) 998-4100

2650 Ridge Ave
Evanston, IL 60201-1700

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

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

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

2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800

Organizations & group practices 3

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 2

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1215822580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "fax_number": "847-982-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765080",
            "telephone_number": "847-982-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Pfingsten Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261301",
            "country_code": "US",
            "telephone_number": "847-657-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9650 Gross Point Rd Ste 4900",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600765080",
            "country_code": "US",
            "telephone_number": "847-444-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "HANNAH",
        "middle_name": "BLOOM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.