NPIMap

Individual provider Active NPI

Inna Podoksik, MD

  • Internal Medicine Physician
  • Vernon Hills, IL
National Provider Identifier
1679632129
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-111764 Issued in IL
Practice address
225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone
(847) 941-7600
Fax
(847) 941-7698
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-111764 IL Primary

Addresses

Primary practice location

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304

Mailing address

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1206

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ipodoksik19280@direct.northshore.org

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
I20040925000113 IL Practitioner - Internal Medicine 7214906478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone (847) 941-7600

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111764ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Aug 4, 2004 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 4, 2004 Accepting new patients
Glenbrook Hospital Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

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

2650 Ridge Ave
Rm 1223
Evanston, IL 60201
Phone (847) 570-1644

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

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

830 W End Ct
Ste 500
Vernon Hills, IL 60061
Phone (847) 522-8900

225 N Milwaukee Ave
Vernon Hills, IL 60061
Phone (847) 941-7600

Interoperability endpoints

  • Direct secure messaging: ipodoksik19280@direct.northshore.org

Organizations & group practices 3

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 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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1679632129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "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": "225 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600614304",
            "telephone_number": "847-941-7600",
            "fax_number": "847-941-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOKSIK",
        "first_name": "INNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-111764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ipodoksik19280@direct.northshore.org",
            "affiliation": "N",
            "address_1": "225 N Milwaukee Ave",
            "city": "Vernon Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600614304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.