Individual provider Active NPI

Edward A Blumen, M.D.

  • Family Medicine Physician
  • Evanston, IL
National Provider Identifier
1659310894
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036049397 Issued in IL
Practice address
909 Davis St
Suite 200
Evanston, IL 60201-3645
Phone
(847) 866-3700
Fax
(847) 866-3731
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036049397 IL Primary

Addresses

Primary practice location

909 Davis St
Suite 200
Evanston, IL 60201-3645

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 570-1206

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eblumen1457@direct.northshore.org

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
I20050906000285 IL Practitioner - Family Practice 0446282099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1973
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)

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000468ILMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jun 1, 1998 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 1, 1998 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

909 Davis St
Ste 200
Evanston, IL 60201
Phone (847) 866-3700

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

909 Davis St
Evanston, IL 60201
Phone (847) 733-7906

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

2650 Ridge Ave
Rm 1210
Evanston, IL 60201
Phone (847) 570-1206

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

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

Interoperability endpoints

  • Direct secure messaging: eblumen1457@direct.northshore.org

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 5

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1659310894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "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": "909 DAVIS ST",
            "address_2": "SUITE 200",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013645",
            "telephone_number": "847-866-3700",
            "fax_number": "847-866-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMEN",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036049397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eblumen1457@direct.northshore.org",
            "affiliation": "N",
            "address_1": "909 Davis St",
            "address_2": "Suite 200",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602013645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.