Douglas Evans, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

36110469 Issued in IL

Practice address

2160 S 1St Ave
Maguire 1700
Maywood, IL 60153-3328

Phone

(708) 216-3280

Fax

(708) 216-6223

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Orthopedic SurgeryAlso: Physical Medicine and Rehabilitation

Education

State University of New York at Buffalo School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
• Macneal Hospital Hospital, Berwyn, IL, CCN 140054
• Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

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

• Gottlieb Community Health Services Corporation

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1295710580
  Care Compare affiliation
• Gottlieb Memorial Hospital

  • General Acute Care Hospital
  • Melrose Park, IL
  • NPI 1831170232
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1700850005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "MAGUIRE 1700",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3280",
            "fax_number": "708-216-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "MAGUIRE 1700",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3280",
            "fax_number": "708-216-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "36110469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36110469",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "devans11126@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "address_2": "Maguire 1700",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica Esmail, MD
• Morgan Sierra Eso, DPM
• Baltazar Remigio Espiritu, MD
• Essence of Love Foundation NFP
• Anna Eursiriwan, PHARMD
• Jamie Lorraine Evans, M.D., M.P.H.
• Joshua David Evans, M.D.
• Nora Catherine Evans, DPT
• Jane Nguyen Ewing
• F&L 9K Transportation LLC

• Sports Medicine (Orthopaedic Surgery) Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.