Individual provider Active NPI

Angela Mark, MD

  • Neurology Physician
  • Evanston, IL
National Provider Identifier
1225155955
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036.123226 Issued in IL
Practice address
1000 Central St Ste 880
Evanston, IL 60201-1780
Phone
(847) 570-2570
NPI assigned
Mar 26, 2007
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301085650 MI
Neurology Physician 2084N0400X 036.123226 IL Primary

Addresses

Primary practice location

1000 Central St Ste 880
Evanston, IL 60201-1780

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amark217156@direct.northshore.org
Direct Messaging Address amark217156@direct.northshore.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
I20101028001408 IL Practitioner - Neurology 1052505583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Johns Hopkins University School of Medicine, 2005
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)

2650 Ridge Ave
Suite 1155
Evanston, IL 60201-1700
Phone (847) 570-1070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.123226ILMDNeurology Physician
4301085650MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 9, 2010 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 9, 2010 Accepting new patients

Locations

1725 W Harrison St
Ste 1118
Chicago, IL 60612
Phone (312) 942-5936

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

1000 Central St
Ste 880
Evanston, IL 60201
Phone (847) 570-2825

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 1155
Evanston, IL 60201
Phone (847) 570-1070

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

2650 Ridge Ave
Ste G155
Evanston, IL 60201
Phone (847) 570-1600

Interoperability endpoints

  • Direct secure messaging: amark217156@direct.northshore.org

Organizations & group practices 2

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 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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1225155955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 880",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011780",
            "telephone_number": "847-570-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301085650",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036.123226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amark217156@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1725 W Harrison St",
            "address_2": "Suite 1118",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amark217156@direct.northshore.org",
            "affiliation": "N",
            "address_1": "1000 Central St Ste 880",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.