Individual provider Active NPI

Henry C Echiverri, MD

  • Neurology Physician
  • Warrenville, IL
National Provider Identifier
1356347264
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036075202 Issued in IL
Practice address
3S 517 Winfield Rd
Ste a
Warrenville, IL 60555-3159
Phone
(630) 836-9121
Fax
(630) 836-9126
NPI assigned
Jun 24, 2005
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 036075202 IL
Neurology Physician 2084N0400X 036075202 IL Primary

Addresses

Primary practice location

3S 517 Winfield Rd
Ste a
Warrenville, IL 60555-3159

Mailing address

3S 517 Winfield Rd
Ste a
Warrenville, IL 60555-3159
Phone (630) 836-9121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hechiverri15728@direct.edward.org Direct

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
I20040621000792 IL Practitioner - Neurology 7012992498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036075202ILMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 14, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 14, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jun 11, 2012 Accepting new patients
Edward Health Ventures CurrentSince Jun 11, 2012 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

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

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

6701 US Highway 34
Oswego, IL 60543
Phone (630) 646-4200

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

3S517 Winfield Rd
Warrenville, IL 60555
Phone (630) 836-9121

3S517 Winfield Rd
Ste A
Warrenville, IL 60555
Phone (630) 836-9121

Interoperability endpoints

  • Direct secure messaging: hechiverri15728@direct.edward.org

Organizations & group practices 5

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 4

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1356347264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3S 517 WINFIELD RD",
            "address_2": "STE A",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553159",
            "telephone_number": "630-836-9121",
            "fax_number": "630-836-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3S 517 WINFIELD RD",
            "address_2": "STE A",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553159",
            "telephone_number": "630-836-9121",
            "fax_number": "630-836-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHIVERRI",
        "first_name": "HENRY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036075202",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036075202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hechiverri15728@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "3S 517 Winfield Rd",
            "address_2": "Ste A",
            "city": "Warrenville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605553159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.