Individual provider Active NPI

Edie Hardin

  • Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1417520149
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008661 Issued in IL
Practice address
880 W Central Rd Ste 4500
Arlington Heights, IL 60005-2388
Phone
(847) 398-2777
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 085.008661 IL Primary

Addresses

Primary practice location

880 W Central Rd Ste 4500
Arlington Heights, IL 60005-2388

Mailing address

12531 E Meadow Dr
Wichita, KS 67206-4152
Phone (316) 644-5295

Other practice location 1

1051 W Rand Rd Ste 210
Arlington Heights, IL 60004-2315
Phone (847) 618-9550

Other identifiers 1

IdentifierTypeStateIssuer
085008661OtherILSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehardin147539@direct.nch.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220105001288 IL Practitioner - Physician Assistant 6103217963 Reassigns benefits to 2 organizations
I20260410001246 SC Practitioner - Physician Assistant 6103217963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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)

1200 W Algonquin Rd
Palatine, IL 60067-7373
Phone (847) 618-0535

2650 Ridge Ave
Evanston, IL 60201-1700

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008661ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Multi-Specialty CurrentSince Dec 12, 2023 Accepting new patients
Northwest Community Health Services Inc Multi-Specialty CurrentSince Jan 24, 2022 Accepting new patients
Northwest Community Health Services Inc Multi-Specialty CurrentSince Jan 24, 2022 Accepting new patients

Locations

1051 W Rand Rd
Ste 210
Arlington Heights, IL 60004
Phone (847) 725-8401

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

880 W Central Rd
Ste 4500
Arlington Hts, IL 60005
Phone (847) 398-2777

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
Evanston, IL 60201
Phone (847) 570-1206

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

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

Interoperability endpoints

  • Direct secure messaging: ehardin147539@direct.nch.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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1417520149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12531 E MEADOW DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672064152",
            "telephone_number": "316-644-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 4500",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052388",
            "telephone_number": "847-398-2777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 W Rand Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600042315",
            "country_code": "US",
            "telephone_number": "847-618-9550",
            "fax_number": "847-618-9510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "EDIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085008661",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehardin147539@direct.nch.org",
            "affiliation": "N",
            "address_1": "1051 W Rand Rd Ste 210",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600042315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.