Individual provider Active NPI

Amy Lynn-Engfer Marr

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1720831332
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2025026423 Issued in MO
Practice address
2650 Ridge Ave Ste 1304
Evanston, IL 60201-1700
Phone
(847) 570-2700
Fax
(847) 570-2822
NPI assigned
Apr 11, 2024
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 2025026423 MO Primary

Addresses

Primary practice location

2650 Ridge Ave Ste 1304
Evanston, IL 60201-1700

Mailing address

1 Hospital Dr # Dc069.10
Columbia, MO 65212-1000
Phone (573) 882-1026

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
I20250108000661 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6103354949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025026423MOMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1720831332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC069.10",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-882-1026",
            "fax_number": "573-884-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1304",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2700",
            "fax_number": "847-570-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARR",
        "first_name": "AMY",
        "middle_name": "LYNN-ENGFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2025026423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.