Individual provider Active NPI

Carolyn K Donaldson, MD

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1477629541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Practice address
2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone
(847) 570-2475
Fax
(847) 570-2942
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1206

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
I20060419000008 IL Practitioner - Diagnostic Radiology 1355330697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loyola University of Chicago, Stritch School of Medicine, 1987
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)

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2100 Pfingsten Rd
Glenview, IL 60026-1301

211 Waukegan Rd
Suite 200
Northfield, IL 60093-2724
Phone (847) 767-3718

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone (847) 941-7600

2650 Ridge Ave
Evanston, IL 60201-1700

3122 N Ashland Ave
Chicago, IL 60657-3014
Phone (773) 687-0999

6141 N Cicero Ave
Chicago, IL 60646-4303
Phone (847) 866-7846

680 N Lake Shore Dr
Suite 115
Chicago, IL 60611-4495
Phone (847) 509-1818

680 N Lake Shore Dr
Suite 924
Chicago, IL 60611-8701
Phone (312) 664-6848

777 Park Ave W
Highland Park, IL 60035-2433

7900 Rollins Rd
Gurnee, IL 60031-1512

920 Milwaukee Ave
Lincolnshire, IL 60069-3839
Phone (847) 866-7846

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

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
036079327ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 25, 2009 Accepting new patients
Affiliated Radiologists, SC Past Accepting new patients

Locations

1725 W Harrison St
Ste 456
Chicago, IL 60612
Phone (312) 563-4238

9532 Eagle Way
Chicago, IL 60678

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

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

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

830 W End Ct
Ste 500
Vernon Hills, IL 60061
Phone (847) 522-8900

Organizations & group practices 3

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 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477629541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1206",
            "fax_number": "847-570-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2475",
            "fax_number": "847-570-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "CAROLYN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.