NPIMap

Individual provider Active NPI

Ginny L Hendricks, M.D.

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1487883831
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.129996 Issued in IL
Practice address
2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735
Phone
(708) 425-9550
Fax
(708) 229-6084
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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 11015167A IN
Family Medicine Physician 207Q00000X 036.129996 IL Primary

Addresses

Primary practice location

2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735

Mailing address

2850 W 95TH St
Suite 101
Evergreen Park, IL 60805-2735
Phone (708) 425-9550

Other names 1

  • Ginny L Carlson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130601000088 IL Practitioner - Family PracticePractitioner - Sports Medicine 3779721808 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 499-2070

2850 W 95TH St
Evergreen Park, IL 60805-2703

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.129996ILMDFamily Medicine Physician
11015167AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System Current Accepting new patients
Osf Healthcare System CurrentSince Aug 18, 2020 Accepting new patients
Osf Healthcare System CurrentSince Aug 18, 2020 Accepting new patients
Little Company of Mary Affiliated Services Inc Current Accepting new patients
Little Company of Mary Affiliated Services Inc CurrentSince Aug 12, 2013 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Feb 1, 2020 Accepting new patients

Locations

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

2850 W 95th St
Ste 101
Evergreen Pk, IL 60805
Phone (708) 425-9550

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

5660 W 95th St
Oak Lawn, IL 60453
Phone (708) 499-2273

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy CircleChicago, IL, CCN 146174 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2025
Aug 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Mercy Circle
    • Skilled Nursing Facility
    • Chicago, IL
    • NPI 1821439738

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 7

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 10

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1487883831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-425-9550",
            "fax_number": "708-229-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "GINNY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11015167A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.129996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINNY",
            "last_name": "CARLSON",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.