Active NPI
Katharine Minot Porter, M.D.
- Psychiatry Physician
- Evanston, IL
National Provider Identifier
1316115363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 36-114816
- Practice address
- 636 Church St
Suite 610
Evanston, IL 60201-4508 - Phone
- (847) 864-9055
- Fax
- (847) 864-1998
- NPI assigned
- Feb 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 36-114816 | IL | Primary |
Addresses
Primary practice location
636 Church St
Suite 610
Evanston, IL 60201-4508
Mailing address
636 Church St
Suite 610
Evanston, IL 60201-4508
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jul 5, 2012 through Jul 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-114816 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1316115363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 CHURCH ST",
"address_2": "SUITE 610",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "636 CHURCH ST",
"address_2": "SUITE 610",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014508",
"telephone_number": "847-864-9055",
"fax_number": "847-864-1998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "KATHARINE",
"middle_name": "MINOT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-12",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "36-114816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.