Individual provider Active NPI

John Martin Vainder, MD

  • Gastroenterology Physician
  • Evanston, IL
National Provider Identifier
1508858226
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036-057977 Issued in IL
Practice address
800 Austin St
Suite 505 West Tower
Evanston, IL 60202-3439
Phone
(847) 491-9020
Fax
(847) 491-0182
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036-057977 IL Primary

Addresses

Primary practice location

800 Austin St
Suite 505 West Tower
Evanston, IL 60202-3439

Mailing address

20 Tower CT
Suite C
Gurnee, IL 60031-5711
Phone (847) 244-2960

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
I20100107000562 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 1850341660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-057977ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Jun 1, 2010 Accepting new patients
Lake Shore Gastroenterolgy SC Gastroenterology Past Accepting new patients

Locations

1100 W Central Rd
Arlington Hts, IL 60005
Phone (847) 259-2410

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

20 Tower Ct
Ste C
Gurnee, IL 60031
Phone (847) 244-2960

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1508858226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TOWER CT",
            "address_2": "SUITE C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315711",
            "telephone_number": "847-244-2960",
            "fax_number": "847-244-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 505 WEST TOWER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-491-9020",
            "fax_number": "847-491-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAINDER",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-057977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.