NPIMap

Individual provider Active NPI

Evelyn Ganaden Basco, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1669531679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36-055675 Issued in IL
Practice address
3900 W Madison
Chicago, IL 60624
Phone
(773) 533-3440
Fax
(773) 722-1200
NPI assigned
Dec 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 36-055675 IL Primary

Addresses

Primary practice location

3900 W Madison
Chicago, IL 60624

Mailing address

3900 W Madison
Chicago, IL 60624
Phone (773) 533-3440

Other identifiers 1

IdentifierTypeStateIssuer
036055675MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140917002234 CA Practitioner - Preventive Medicine 3870643778 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Physicians Medical Allied Group IncGroup PAC ID 7810233491, 2 clinicians

Practice addresses (Care Compare)

818 W Cameron Ave
West Covina, CA 91790-4136
Phone (626) 337-6246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36-055675ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Physicians Medical Allied Group Inc Family Medicine CurrentSince Nov 1, 2025 Accepting new patients
Global Integrated Medical Group, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Global Medical GRP Inc CurrentSince Feb 10, 2021 Accepting new patients
Rapha Apmc PastSince Dec 15, 2025 Accepting new patients
Dr Evelyn G Basco MD, SC Past Accepting new patients
Pure Care Hospice, Inc. Family Medicine PastSince Apr 4, 2024 Accepting new patients

Locations

1535 W Merced Ave
Ste 202
West Covina, CA 91790
Phone (626) 337-6246

818 W Cameron Ave
West Covina, CA 91790
Phone (626) 264-8847

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Embrace HealthcareNorth Hollywood, CA, CCN 751620 Hospice W-2 Managing Employee May 29, 2017
Pure Care Hospice IncCerritos, CA, CCN B21699 Hospice W-2 Managing Employee (100%) Apr 4, 2024

Owned or controlled facilities with NPI records 2

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669531679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W MADISON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60624",
            "telephone_number": "773-533-3440",
            "fax_number": "773-722-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W MADISON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60624",
            "telephone_number": "773-533-3440",
            "fax_number": "773-722-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCO",
        "first_name": "EVELYN",
        "middle_name": "GANADEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36-055675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055675",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.