Evan Michael Whitenack, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

1611 W Harrison St
Chicago, IL 60612-4861

Phone

(224) 254-6076

NPI assigned

Apr 25, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451

  IN

  Medicare reassignment

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1275988438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 W EVERGREEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223016",
            "telephone_number": "248-760-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "224-254-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENACK",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zephaniah Sharnaeshavon Whitehead
• Jeffrey J Whitehouse, M.D.
• Michaela Whitelaw
• Patrick Michael Whiteley, MD
• Leah Whiteman
• Emilie Whitesell, M.S., CCC-SLP
• Matthew Robert Whitesell, MSA, ATC
• Brenda K Whiteside
• Louis A Whitesman, DDS MS
• Earline Mekazin Whitfield-Alexander

• Surgical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.