Individual provider Active NPI

Evans R Sirois, D.O

  • Internal Medicine Physician
  • Mt Prospect, IL
National Provider Identifier
1356310262
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036109044 Issued in IL
Practice address
199 W Rand Rd Ste 203
Mt Prospect, IL 60056-1157
Phone
(847) 618-5450
Fax
(847) 618-5459
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036109044 IL Primary

Addresses

Primary practice location

199 W Rand Rd Ste 203
Mt Prospect, IL 60056-1157

Mailing address

199 W Rand Rd Ste 203
Mt Prospect, IL 60056-1157
Phone (847) 618-5450

Other identifiers 1

IdentifierTypeStateIssuer
036109044OtherILSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address esirois136555@direct.nch.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
I20090401000296 IL Practitioner - HospitalistPractitioner - Internal Medicine 6406913789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1999
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)

1051 W Rand Rd
Arlington Heights, IL 60004-2315

199 W Rand Rd
Mount Prospect, IL 60056-1151
Phone (847) 618-5400

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Residential Home Health Home health agency, Schaumburg, IL, CCN 147094
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Northwest Community Health Services Inc CurrentSince May 15, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 27, 2023 Accepting new patients
Northwest Community Health Services Inc Internal Medicine CurrentSince May 15, 2020 Accepting new patients

Locations

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

25233 Network Pl
Chicago, IL 60673

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

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

199 W Rand Rd
Mt Prospect, IL 60056
Phone (847) 618-5400

199 W Rand Rd
Ste 203
Mt Prospect, IL 60056
Phone (847) 618-5450

Organizations & group practices 4

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 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1356310262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 W RAND RD STE 203",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600561157",
            "telephone_number": "847-618-5450",
            "fax_number": "847-618-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 W RAND RD STE 203",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600561157",
            "telephone_number": "847-618-5450",
            "fax_number": "847-618-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROIS",
        "first_name": "EVANS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036109044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036109044",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "esirois136555@direct.nch.org",
            "affiliation": "N",
            "address_1": "199 W Rand Rd Ste 203",
            "city": "MT Prospect",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600561157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mt Prospect, IL

Sources for this page

Verify at the official NPI Registry.