NPIMap

Individual provider Active NPI

Olena Gordon, M.D.

  • Family Medicine Physician
  • Niles, IL
National Provider Identifier
1528309705
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036131766 Issued in IL
Practice address
8937 W Golf Rd
Niles, IL 60714-5812
Phone
(847) 375-9711
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Family Medicine Physician 207Q00000X 036131766 IL Primary

Addresses

Primary practice location

8937 W Golf Rd
Niles, IL 60714-5812

Mailing address

8937 W Golf Rd
Niles, IL 60714-5812
Phone (847) 375-9711

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
I20130927000388 IL Practitioner - Family Practice 7618101924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8937 W Golf Rd
Niles, IL 60714-5812
Phone (847) 375-9711

Hospital & facility affiliations

  • Reliable Home Care Provider, Inc Home health agency, Lincolnshire, IL, CCN 148194
  • Vita Health Care, Inc Home health agency, Northbrook, IL, CCN 148153
  • Providence Home Health Care, I Home health agency, Northbrook, IL, CCN 147710
  • Progressive Home Health Care Home health agency, Northbrook, IL, CCN 147697
  • Solaris Home Healthcare Home health agency, Northbrook, IL, CCN 148280
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as individual
Quality
74.96
Improvement activities
40
Cost
63.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036131766ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Medical Center LLC Family Medicine CurrentSince Mar 5, 2019 Accepting new patients
Hias Diagnostics Inc Past Accepting new patients

Locations

8937 W Golf Rd
Niles, IL 60714
Phone (847) 375-9711

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 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": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1528309705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "847-375-9711",
            "fax_number": "847-375-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8937 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "847-375-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "OLENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.