Individual provider Active NPI

Adam W. Bennett, MD

  • Sports Medicine (Family Medicine) Physician
  • Lake Forest, IL
National Provider Identifier
1376595025
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
036106759 Issued in IL
Practice address
1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone
(847) 535-8500
Fax
(847) 535-8488
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036106759 IL
Sports Medicine (Family Medicine) Physician 207QS0010X 036106759 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone (847) 535-8500

Other practice location 1

680 N Lake Shore Dr
Suite 1028
Chicago, IL 60611-4546
Phone (312) 664-6848

Other practice location 2

680 N Lake Shore Dr Ste 924
Chicago, IL 60611
Phone (847) 866-7846

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
I20061206000476 IL Practitioner - Sports MedicinePractitioner - Family PracticePractitioner - Internal Medicine 0143229849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Family Medicine CurrentSince Dec 12, 2011 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 1, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 12, 2011 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 1, 2020 Accepting new patients
Central Dupage Physician Group Family Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

9532 Eagle Way
Chicago, IL 60678

680 N Lake Shore Dr
Chicago, IL 60611
Phone (312) 503-6000

680 N Lake Shore Dr
Ste 924
Chicago, IL 60611
Phone (312) 475-5628

680 N Lake Shore Dr
Ste 1028
Chicago, IL 60611
Phone (312) 335-9333

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

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

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1704 Maple Ave
Ste 200
Evanston, IL 60201
Phone (847) 535-8500

2501 Compass Rd
Ste 125
Glenview, IL 60026
Phone (847) 250-1130

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1000 N Westmoreland Rd
Fl 3
Lake Forest, IL 60045
Phone (847) 535-6615

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

1875 W Dempster St
Ste 405
Park Ridge, IL 60068
Phone (312) 372-6644

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 and National Provider Directory roles.

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1376595025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-8500",
            "fax_number": "847-535-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-8500",
            "fax_number": "847-535-8488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr",
            "address_2": "Suite 1028",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114546",
            "country_code": "US",
            "telephone_number": "312-664-6848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 N Lake Shore Dr Ste 924",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "847-866-7846",
            "fax_number": "866-954-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ADAM",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036106759",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036106759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.