Individual provider Active NPI

Brian Dominic Bordini, M.D.

  • Pediatric Endocrinology Physician
  • Skokie, IL
National Provider Identifier
1376717900
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
036.113918 Issued in IL
Practice address
9977 Woods Dr Ste 300
Skokie, IL 60077-1057
Phone
(847) 663-8508
NPI assigned
Apr 15, 2008
Last updated
Apr 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 036.113918 IL Primary

Addresses

Primary practice location

9977 Woods Dr Ste 300
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr Ste 300
Skokie, IL 60077-1057
Phone (847) 663-8508

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbordini262297@direct.northshore.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
I20080919000574 IL Practitioner - EndocrinologyPractitioner - Pediatric Medicine 6507933306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.113918ILMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 1, 2016 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2016 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

9977 Woods Dr
Fl 2
Skokie, IL 60077
Phone (847) 663-8163

9977 Woods Dr
Ste 300
Skokie, IL 60077
Phone (847) 663-8508

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1376717900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDINI",
        "first_name": "BRIAN",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036.113918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbordini262297@direct.northshore.org",
            "affiliation": "N",
            "address_1": "9977 Woods Dr Ste 300",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600771057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.