Individual provider Active NPI

Monika Zeromska-Cancellaro, MD

  • Obstetrics & Gynecology Physician
  • Evanston, IL
National Provider Identifier
1730111097
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-108700 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2860
Fax
(847) 570-2910
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-108700 IL Primary
Hospitalist Physician 208M00000X 036108700 IL

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2368 Paysphere Cir
Chicago, IL 60674-2368

Other practice location 1

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-8400

Other practice location 2

3722 Harlem Ave Lowr Level-34
Riverside, IL 60546-2312
Phone (708) 783-7840

Other identifiers 1

IdentifierTypeStateIssuer
036108700MedicaidIL

Other names 1

  • Monika Cancellaro Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mzeromskacancellaro20718@direct.nch.org

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
I20041022001143 IL Practitioner - HospitalistPractitioner - Obstetrics/Gynecology 3476514548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-108700ILMDObstetrics & Gynecology Physician
036108700ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Nov 19, 2020 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology CurrentSince Jul 22, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 22, 2021 Accepting new patients
VHS of Illinois Inc Obstetrics & Gynecology Past Accepting new patients
Northwest Community Physicians Association LLC Obstetrics & Gynecology Past Accepting new patients

Locations

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

3249 Oak Park Ave
Fl 4
Berwyn, IL 60402
Phone (708) 783-7850

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

9532 Eagle Way
Chicago, IL 60678

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

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

Interoperability endpoints

  • Direct secure messaging: mzeromskacancellaro20718@direct.nch.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1730111097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2368 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2860",
            "fax_number": "847-570-2910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Central Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052349",
            "country_code": "US",
            "telephone_number": "847-618-8400",
            "fax_number": "847-618-8409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3722 Harlem Ave Lowr Level-34",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "IL",
            "postal_code": "605462312",
            "country_code": "US",
            "telephone_number": "708-783-7840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEROMSKA-CANCELLARO",
        "first_name": "MONIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-108700",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036108700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108700",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mzeromskacancellaro20718@direct.nch.org",
            "affiliation": "N",
            "address_1": "800 W Central Rd",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600052349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MONIKA",
            "last_name": "CANCELLARO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.