Individual provider Active NPI

Adina Hattar, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1710347406
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-005775 Issued in IL
Practice address
675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929
Phone
(312) 695-8630
Fax
(312) 695-2857
NPI assigned
Feb 24, 2016
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-005775 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929

Mailing address

675 N Saint Clair St Ste 18-200
Chicago, IL 60611-5929
Phone (312) 695-8630

Other identifiers 1

IdentifierTypeStateIssuer
F400295875OtherILMEDICARE PTAN FRANCISCAN ALLIANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahattar222678@Direct.FranciscanAlliance.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512000365 IL Practitioner - Physician Assistant 5294024469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-005775ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC CurrentSince Jul 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2021 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

35318 Eagle Way
Chicago, IL 60678

675 N Saint Clair St
Ste 18-200
Chicago, IL 60611
Phone (312) 695-4525

18636 Dixie Hwy
Homewood, IL 60430
Phone (708) 647-0571

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

3700 W 203rd St
Ste 103
Olympia Flds, IL 60461
Phone (708) 679-2130

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

Interoperability endpoints

  • Direct secure messaging: ahattar222678@direct.franciscanalliance.org

Organizations & group practices 4

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 1

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": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1710347406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115929",
            "telephone_number": "312-695-8630",
            "fax_number": "312-695-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115929",
            "telephone_number": "312-695-8630",
            "fax_number": "312-695-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTAR",
        "first_name": "ADINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN FRANCISCAN ALLIANCE",
            "identifier": "F400295875",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahattar222678@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3700 W 203rd St",
            "address_2": "Suite 301",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.