Madhuri V Konanahalli, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036118314 Issued in IL

Practice address

1000 Central St Ste 800
Evanston, IL 60201

Phone

(847) 663-8060

Fax

(847) 663-1027

NPI assigned

Aug 28, 2007

Last updated

Jul 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003

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)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Dermatology

  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1568656130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 800",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011780",
            "telephone_number": "847-663-8060",
            "fax_number": "847-663-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 800",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-663-8060",
            "fax_number": "847-663-1027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Lake Cook Rd",
            "address_2": "Suite #280",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600155613",
            "country_code": "US",
            "telephone_number": "847-480-0004",
            "fax_number": "847-480-8707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONANAHALLI",
        "first_name": "MADHURI",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036118314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharona Kolesnikov
• Samantha Valentine Kolkey, LCSW
• Terrence James Koller, PH.D.
• Ludmila Kolomay, FNP
• Ella Komarovsky, M.D.
• Athanasios Kondilis, DO/PHD
• Dalia Esmeralda Koo
• Wendy Kopald, LCSW
• Shannon Lynn Kopecky, CRNA
• Theresa Marie Kopitzke, LCPC

• Dermatology Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.